Techniques and Lessons Learned: What to Know About Single-Port Extraperitoneal Radical Prostatectomy

Early experiences and outcomes on the brink of 200 cases

Cleveland Clinic was the first U.S. medical center to begin using the single-port (SP) robot for urologic procedures in late 2018. Since then, experts at Glickman Urological & Kidney Institute continue to fine-tune their surgical technique.

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Jihad Kaouk, MD, Director of the Center for Robotic and Image-Guided Surgery and the Zegarac-Pollock Endowed Chair in Laparoscopic and Robotic Surgery, elaborates on the benefits of performing the prostate cancer surgery extraperitoneally, noting, “By avoiding the sac in which the bowel is contained, the surgery is compartmentalized, limited to the area just around the prostate. The gas bubble in which the robotic arms work expands the peritoneum, pushing the bowel out of the way, allowing better visibility.”

In addition, the SP robotic technique avoids the steep Trendelenburg positioning, which improves recovery time and mitigates potential risks associated with such positioning, including optical nerve edema, congestion and respiratory problems during surgery. Patients undergoing the procedure with SP robotic prostatectomy lie flat.

These key differences in the technique allow for faster recovery, reduced postoperative pain and shorter hospital stay.

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They shared these experiences using the SP robot to perform extraperitoneal radical prostatectomy recently at the American Urological Association 2021 Annual Meeting.

Learn more in their virtual presentation: