Comparison of perioperative and functional outcomes of single-incision versus standard multi-incision robot-assisted laparoscopic radical prostatectomy: a prospective, controlled, nonrandomized trial

To compare perioperative and functional outcomes between improved (port-free) single-site robot-assisted laparoscopic radical prostatectomy (pf-ssRARP) and standard multi-port robot-assisted radical prostatectomy (MPRARP).

A total of 372 consecutive patients underwent RARAP using the da Vinci Si^® robotic surgical system.

Group I ( n  = 210) included patients undergoing pf-ssRARP and Group II ( n  = 162) included patients undergoing MPRARP.

Demographics and perioperative data including postoperative recovery outcomes were recorded and compared between the two groups.

Overall mean operative time was significantly shorter with the pf-ssRARP compared to the MPRARP ( p  < 0.05).

The length of hospitalization after the pf-ssRARP was shorter ( p  < 0.05).

In Group I, the positive surgical margin rate was 15.2%; while in Group II, the positive margin rate was 33.3% ( p  < 0.05).

The rate of instant urinary continence was significantly higher in Group I than in Group II ( p  < 0.05).

The percentage of urinary continence was higher in the pf-ssRARP than in the MPRARP, at 6 months post-surgery ( p  < 0.05) and 9 months post-surgery ( p  < 0.05).

There was no significant difference in the proportion of erectile function in the pf-ssRARP and MPRARP groups at the time of reaching the endpoint of this study ( p  > 0.05).

The two groups were comparable in terms of total hospitalization costs ( p  < 0.05).

The improved (port-free) single-site robot-assisted laparoscopic radical prostatectomy is a practical and easy technique to implement in clinical practice.

Extraperitoneal implementation of the modified technique requires only a small incision, no special PORT, no additional auxiliary foramen creation, increased postoperative aesthetics and reduced hospitalization costs, and a high percentage of early postoperative urinary control recovery.