Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jul-Aug;48(4):696-705.
doi: 10.1590/S1677-5538.IBJU.2022.99.16.

Contemporary techniques of da Vinci SP radical prostatectomy: multicentric collaboration and expert opinion

Marcio Covas Moschovas  1   2 , Isabella Brady  1 , Jonathan Noel  1 , Mahmoud Abou Zeinab  3 , Aaron Kaviani  3 , Jihad Kaouk  3 , Simone Crivellaro  4 , Jean Joseph  5 , Alexandre Mottrie  6 , Vipul Patel  1   2
Affiliations

Contemporary techniques of da Vinci SP radical prostatectomy: multicentric collaboration and expert opinion

Marcio Covas Moschovas et al. Int Braz J Urol. 2022 Jul-Aug.

Abstract

Background: The da Vinci SP robot consists of an innovative single port trocar that houses a flexible camera and three biarticulated arms, which minimizes the number of incisions to assess the surgical site, allowing a less invasive procedure. However, due to its recent release in the market, the current literature reporting SP-RARP is still restricted to a few centers. In this scenario, after performing a literature search with all available techniques of SP-RARP, our objective is to report a multicentric opinion of referral centers on different techniques to approach SP-RARP.

Results: The SP literature is provided by only a few centers due to the limited number of this new console in the market. Five different approaches are available: transperitoneal, extraperitoneal, Retzius-Sparing, transperineal and transvesical. None of the current studies describe long-term functional or oncological outcomes. However, all approaches had satisfactory operative performance with minimum complication rates.

Conclusions: Several techniques of SP-RARP have been reported in the literature. We performed a multicentric collaboration describing and illustrating the most challenging steps of this surgery. We believe that the details provided in this article are useful teaching material for new centers willing to adopt the SP technology.

Keywords: Prostatectomy; Robotic Surgical Procedures; methods [Subheading].

PubMed Disclaimer

Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1. SP trocar and instruments attached to the robotic arm.
Figure 2
Figure 2. A) SP Access Kit (Intuitive). B) Mini Gel Point (Applied Medical) with an assistant trocar placed laterally.
Figure 3
Figure 3. SP+ one transperitoneal trocar placement.
Figure 4
Figure 4. SP Retzius-sparing: anterior bladder neck approach (Cadiere at 12 holding the bladder
Figure 5
Figure 5. Single-port transvesical robot-assisted radical prostatectomy. The patient is kept in a supine position. The camera and instruments are introduced directly into the urinary bladder.
Figure 6
Figure 6. Single-port transperineal robot-assisted radical prostatectomy. An Illustration of the SP robot docked to the perineum, while the patient is in a high lithotomy position.
See this image and copyright information in PMC

References

    1. Yates DR, Vaessen C, Roupret M. From Leonardo to da Vinci: the history of robot-assisted surgery in urology. BJU Int. 2011;108:1708-13; discussion 1714. - PubMed
    1. Kaouk JH, Haber GP, Autorino R, Crouzet S, Ouzzane A, Flamand V, et al. A novel robotic system for single-port urologic surgery: first clinical investigation. Eur Urol. 2014;66:1033-43. - PubMed
    1. Lai A, Dobbs RW, Talamini S, Halgrimson WR, Wilson JO, Vigneswaran HT, et al. Single port robotic radical prostatectomy: a systematic review. Transl Androl Urol. 2020;9:898-905. - PMC - PubMed
    1. Jones R, Dobbs RW, Halgrimson WR, Vigneswaran HT, Madueke I, Wilson J, et al. Single port robotic radical prostatectomy with the da Vinci SP platform: a step by step approach. Can J Urol. 2020;27:10263-9. - PubMed
    1. Covas Moschovas M, Bhat S, Rogers T, Onol F, Roof S, Mazzone E, et al. Technical Modifications Necessary to Implement the da Vinci Single-port Robotic System. Eur Urol. 2020;78:415-23. - PubMed