ArticleCureus2025
Extraperitoneal Single-Port Robot-Assisted Radical Prostatectomy for a Massive Prostate: A Case Report.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Extraperitoneal single-port robot-assisted radical prostatectomy (SP-RARP) using the da Vinci SP system (Intuitive Surgical, Sunnyvale, CA, US) offers a less invasive alternative to multi-port RARP. However, a significant limitation is the system's reduced instrument force, which makes retraction and manipulation of large, heavy organs particularly challenging. As a result, SP-RARP for prostates over 100 g has been considered difficult and is rarely reported. This case highlights the feasibility of extraperitoneal SP-RARP in a patient with a massive prostate by addressing and overcoming this technical limitation. We report the case of a 77-year-old man with bilateral ureteral stones, significant prostatic hypertrophy, and prostate adenocarcinoma (Gleason score 3+3), who underwent extraperitoneal SP-RARP due to urinary retention. The operation lasted 4 hours and 40 minutes, with an estimated blood loss of 450 mL through a 4.5 cm sub-umbilical incision. The prostate weighed 143 g. No intraoperative complications occurred, and the postoperative course was uneventful. SP-RARP for massive prostates (>100 g) remains technically challenging due to the limited retraction force of the single-port system, and successful extraperitoneal cases have not been previously documented. This report demonstrates that, with proper technique, extraperitoneal SP-RARP can be safely and effectively performed even in cases involving significantly enlarged prostates. These findings support the potential expansion of SP-RARP indications in select high-volume cases.
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