Background. Laparoendoscopic single-site radical prostatectomy (LESS-RP) is obtaining popularity. To improve continence and overcome current limitations, transvesical single-port laparoscopic RP could be applied to LESS. Our experience in performing transvesical single-port laparoscopic RP was analyzed.
Methods. A total of 20 consecutive men with organ-confined prostate cancer underwent transvesical single-port laparoscopic RP between November 2010 and July 2011 by a single surgeon. A novel port (QuadPort®) was used percutaneously into the bladder to establish pneumovesicum through a 4-cm bladder incision. All the operative procedures, including incision of the posterior bladder neck, dissection of the seminal vesicles and vas deferens, ligation of prostatic pedicles, preserving of neurovascular bundles, apical dissection, urethral transection, and urethro-vesical anastomosis with ventral inlay forskin graft, were performed transvesically and laparoscopically.
Results. All of the 20 transvesical single-port laparoscopic RP was successfully performed, and there was no conversion to standard laparoscopic approach or open surgery. Patients were hospitalized for a mean (range) of 14.7 (12–25) days after surgery. The total operative time range was 75–180 min, and the mean operative time was 105 min. The estimated blood loss was 75–500 ml, and no blood transfusion was required. Catheters were removed after a mean (range) of 12.1 (9–16) days. No intraoperative complications occurred. No patient had positive surgical margins. All the cases were continent after removal of the catheter.
Conclusions. Transvesical single-port laparoscopic radical prostatectomy is technically feasible for cases with organ-confined prostate cancer.