Intriguing future: single-site robotic-assisted radical prostatectomy

摘要

Single-site robotic-assisted radical prostatectomy (ssRARP) has emerged as a promising advancement in urological surgery, driven by the development of advanced robotic instrumentation and single-port access technologies. Global researchers have extensively explored various techniques and approaches for ssRARP in carefully selected patient populations, yielding promising perioperative and oncological outcomes. This review aims to provide a comprehensive overview of the technical intricacies of ssRARP. We will delve into the evolution of single-port robotic surgery, highlighting key advancements and surgical techniques, including transperitoneal, extraperitoneal, and transvesical approaches. A detailed discussion of technical nuances, challenges, and potential pitfalls will be presented. Furthermore, we will analyze the available evidence regarding the perioperative and oncological outcomes of ssRARP. This includes examining factors such as operative time, blood loss, postoperative complications, length of hospital stay, continence recovery, and biochemical recurrence-free survival, and the challenges and management strategies for patients with specific preoperative situations, such as previous surgery, large median lobe and prostatectomy after focal therapy. The potential advantages of ssRARP, including improved cosmesis, reduced postoperative pain, and faster recovery, will be explored. By providing a comprehensive understanding of the technical aspects, clinical outcomes, and future directions of ssRARP, this review aims to contribute to the ongoing discourse on the role of single-port robotic surgery in prostate cancer management.