Introduction: To present the updated technique and evaluate the perioperative and postoperative outcomes of Single port transvesical simple prostatectomy (SP TVSP)
Methods: Forty-two consecutive patients with BPH indicated for surgery underwent SP TVSP in a single institution. The procedure was performed in the following steps: 1- The Patient was positioned in a supine position. 2- A 3-3.5 cm suprapubic midline incision is made, and a 2 cm vertical cystotomy was performed after bladder identification. 3- After insertion of the access port, the single-port (SP) robot was docked. 4- Identification of the ureteral orifices. 5- Prostatic enucleation was performed using the prostatic capsule as a landmark. 6- Then a complete vesicourethral mucosal advancement flap was accomplished. Demographics, perioperative and postoperative data were prospectively collected. Mean follow-up period was 12 months.
Results: All procedures were successfully performed with no conversion, additional port placement or intraoperative complication. The median prostatic volume was 170cc. 95% of the patients did not require opioids analgesia after discharge. 65% of the last consecutive patients were discharged a few hours after the surgery and had their Foley catheter removed 2-3 days later. The Median IPSS score decreased from 23 before the surgery to 2.5 after the surgery. All patients had a significant postoperative improvement in maximum flow rate with a 200% improvement over baseline (19 vs. 6.5 mL/sec).
Conclusions: In our initial series, SP TVSP allows for favorable perioperative and early postoperative outcomes including low complication same-day discharge, short Foley catheter stay, minimal opioids use and quick recovery.