Extraperitoneal single-port robotic-assisted radical prostatectomy shortens console time by 83 minutes versus multiport transperitoneal approaches in 1997 patients

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Clinical genitourinary cancer Published June 1, 2026 Medically reviewed June 1, 2026 Study authors: Furlam Pedro L, Matalani Caio F A, Lepine Henrique L, da Silva Luiz G P, Shabana Walid, Sharour Wali… PubMed ↗ DOI ↗ By Dr. Julia Lee, PhD · Oncology, Genomics & Drug Development

Key Takeaway

Consider RA-SPRP for shorter console time and hospital stay, though oncologic equivalence remains unproven in randomized trials.

This systematic review and meta-analysis compared extraperitoneal single-port robotic-assisted radical prostatectomy (RA-SPRP) with multiport transperitoneal robotic-assisted radical prostatectomy (RA-MPRP) in a population of 1997 patients undergoing prostatectomy. The primary outcomes assessed included positive surgical margins and biochemical recurrence, while secondary outcomes covered operative metrics and functional recovery.

Significant differences favored RA-SPRP for console time, which was 83 minutes shorter (MD: -83 minutes; 95% CI, -29.61 to -4.05; P < .05). Hospital stay was also significantly shorter by 1.29 days (MD: -1.29 days; 95% CI, -2.55 to -0.02; P < .05). Time to catheter removal was shorter by 2.80 days (MD: -2.80 days; 95% CI, -2.98 to -2.62; P < .05). No significant differences were observed for operative time, estimated blood loss, positive surgical margins, biochemical recurrence, complication rates, continence, or erectile function.

The authors highlight study heterogeneity and methodological limitations, particularly the predominance of retrospective designs. These factors warrant cautious interpretation of the findings. The review supports the feasibility of RA-SPRP in select clinical contexts but underscores the need for randomized controlled trials with standardized protocols to validate these observations regarding perioperative and functional outcomes.

Study Details

Study typeMeta analysis

Sample sizen = 1,997

EvidenceLevel 1

PublishedJun 2026

PMID42108118

View Original Abstract ↓

The emergence of extraperitoneal single-port robotic-assisted radical prostatectomy (RA-SPRP) as a minimally invasive surgical approach has prompted comparisons with the well-established multi-port transperitoneal technique (RA-MPRP). This study aims to systematically review and analyze perioperative, oncologic, and functional outcomes between RA-SPRP and RA-MPRP. A systematic review and meta-analysis were conducted following PRISMA guidelines and registered in PROSPERO (CRD420250648505). Databases including PubMed, EMBASE, SCOPUS, and others were searched up to April 2025. Comparative studies reporting relevant outcomes between RA-SPRP and RA-MPRP were included. Primary endpoints were positive surgical margins and biochemical recurrence. Secondary outcomes included operative time, console time, estimated blood loss, hospital stay, complications, continence, erectile function, and catheter removal time. Methodological quality was assessed using the ROBINS-I tool. Seven studies comprising 1997 patients were included. RA-SPRP demonstrated a significantly shorter console time (MD: -83 minutes; 95% CI, -29.61 to -4.05; P < .05) and hospital stay (MD: -1.29 days; 95% CI, -2.55 to -0.02; P < .05). Time to catheter removal was also shorter in the single-port group (MD: -2.80 days; 95% CI, -2.98 to -2.62; P < .05). No significant differences were observed in operative time, estimated blood loss, positive surgical margins, biochemical recurrence, complication rates, continence, or erectile function. Study heterogeneity and methodological limitations-particularly the predominance of retrospective designs-warrant cautious interpretation. RA-SPRP appears to offer perioperative, oncologic, and functional outcomes comparable to RA-MPRP, with potential advantages in early recovery and shorter hospital stay. These findings support the feasibility of RA-SPRP, especially in select clinical contexts, but underscore the need for randomized controlled trials with standardized protocols to validate these observations.