Purpose: To investigate the feasibility and surgical technique of robotic perineal radical prostatectomy (RPRP). Materials and Methods: We retrospectively analyzed 6 consecutive patients diagnosed with prostate cancer from December 2018 to May 2019 who underwent RPRP at our center. Perioperative outcomes were recorded for safety and feasibility analysis. Results: Six patients successfully underwent RPRP with no conversion to open procedures. Operative time was 140 (interquartile range [IQR] 123.75–148.75) min, console time was 70 (IQR 62.5–70) min, with an estimated blood loss of 125 (IQR 100–187.5) mL. Patients were discharged 2 days postoperatively (IQR range 1–3) with pelvic drainages removed. The Foley catheter was removed 2 weeks after surgery. Postoperative pathology revealed 5 patients with locally advanced disease (apical margin-positive prostate cancer [pT3a]bNx). Two patients had a positive surgical margin (33.3%). No complications of Clavien grade 3 and above were recorded; 1 patient had a delay in wound-healing of 1 week. Postoperative continence was achieved for 2 patients immediately after Foley catheter removal, 2 recovered 1-month postoperatively, and 1 recovered within 3 months, and 1 still had mild incontinence at the latest follow-up 1-month postoperatively. Conclusion: RPRP is a safe and feasible alternative for the transperitoneal route in selected patients. Further investigation is required to assess its oncological and quality-of-life results.

1.
Sriprasad
S
,
Feneley
MR
,
Thompson
PM
.
History of prostate cancer treatment
.
Surg Oncol
.
2009
Sep
;
18
(
3
):
185
91
.
[PubMed]
0960-7404
2.
Young
HH
.
The early diagnosis and radical cure of carcinoma of the prostate. Being a study of 40 cases and presentation of a radical operation which was carried out in four cases. 1905
.
J Urol
.
2002
Sep
;
168
(
3
):
914
21
.
[PubMed]
0022-5347
3.
Millin T. Retropubic prostatectomy; a new extravesical technique; report on 20 cases. Lancet. 1945;246:693–6.
4.
Tinay
I
,
Aslan
G
,
Kural
AR
,
Özen
H
,
Akdoğan
B
,
Yıldırım
A
, et al.;
Members of Urooncology Association
.
Pathologic Outcomes of Candidates for Active Surveillance Undergoing Radical Prostatectomy: Results from a Contemporary Turkish Patient Cohort
.
Urol Int
.
2018
;
100
(
1
):
43
9
.
[PubMed]
0042-1138
5.
Kaouk
JH
,
Akca
O
,
Zargar
H
,
Caputo
P
,
Ramirez
D
,
Andrade
H
, et al.
Descriptive Technique and Initial Results for Robotic Radical Perineal Prostatectomy
.
Urology
.
2016
Aug
;
94
:
129
38
.
[PubMed]
0090-4295
6.
Tuğcu
V
,
Akça
O
,
Şimşek
A
,
Yiğitbaşı
İ
,
Yenice
MG
,
Şahin
S
, et al.
Robotic perineal radical prostatectomy and robotic pelvic lymph node dissection via a perineal approach: The Tugcu Bakirkoy Technique
.
Turk J Urol
.
2018
Mar
;
44
(
2
):
114
8
.
[PubMed]
2149-3235
7.
Tuğcu
V
,
Akça
O
,
Şimşek
A
,
Yiğitbaşı
İ
,
Şahin
S
,
Yenice
MG
, et al.
Robotic-assisted perineal versus transperitoneal radical prostatectomy: A matched-pair analysis
.
Turk J Urol
.
2019
Apr
;
45
(
4
):
265
72
.
[PubMed]
2149-3235
8.
Briganti
A
,
Larcher
A
,
Abdollah
F
,
Capitanio
U
,
Gallina
A
,
Suardi
N
, et al.
Updated nomogram predicting lymph node invasion in patients with prostate cancer undergoing extended pelvic lymph node dissection: the essential importance of percentage of positive cores
.
Eur Urol
.
2012
Mar
;
61
(
3
):
480
7
.
[PubMed]
0302-2838
9.
Chang
Y
,
Qu
M
,
Wang
L
,
Yang
B
,
Chen
R
,
Zhu
F
, et al.
Robotic-assisted Laparoscopic Radical Prostatectomy From a Single Chinese Center: A Learning Curve Analysis
.
Urology
.
2016
Jul
;
93
:
104
11
.
[PubMed]
0090-4295
10.
Chang
Y
,
Lu
X
,
Zhu
Q
,
Xu
C
,
Sun
Y
,
Ren
S
.
Single-port transperitoneal robotic-assisted laparoscopic radical prostatectomy (spRALP): initial experience
.
Asian J Urol
.
2018
.
[PubMed]
2214-3882
11.
Zhai
LD
,
Liu
J
,
Li
YS
,
Ma
QT
,
Yin
P
.
The male rectourethralis and deep transverse perineal muscles and their relationship to adjacent structures examined with successive slices of celloidin-embedded pelvic viscera
.
Eur Urol
.
2011
Mar
;
59
(
3
):
415
21
.
[PubMed]
0302-2838
12.
Laydner
H
,
Akça
O
,
Autorino
R
,
Eyraud
R
,
Zargar
H
,
Brandao
LF
, et al.
Perineal robot-assisted laparoscopic radical prostatectomy: feasibility study in the cadaver model
.
J Endourol
.
2014
Dec
;
28
(
12
):
1479
86
.
[PubMed]
0892-7790
13.
Tuğcu
V
,
Akça
O
,
Şimşek
A
,
Yiğitbaşı
İ
,
Şahin
S
,
Taşçı
AI
.
Robot-assisted radical perineal prostatectomy: first experience of 15 cases
.
Turk J Urol
.
2017
Dec
;
43
(
4
):
476
83
.
[PubMed]
2149-3235
14.
Fujimoto
N
,
Shiota
M
,
Tomisaki
I
,
Minato
A
,
Yahara
K
.
Reconsideration on Clinical Benefit of Pelvic Lymph Node Dissection during Radical Prostatectomy for Clinically Localized Prostate Cancer
.
Urol Int
.
2019
;
103
(
2
):
125
36
.
[PubMed]
0042-1138
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.