The development of single-port (SP) technology in robotic-assisted radical prostatectomy has seen significant progress since the release of the da Vinci SP platform in 2018, encouraging the emergence of other robotic platforms like the Shurui SP. This video compilation provides a detailed comparison of the step-by-step radical prostatectomy techniques employed by the da Vinci SP and Shurui SP robots, from initial trocar placement to final anastomosis. Both platforms can operate through a single trocar or an auxiliary port positioned in the right lower quadrant. When using the extraperitoneal technique, the robotic trocar is positioned midline under the umbilicus, while in the transperitoneal approach, the trocar is placed slightly above the umbilical scar.
The da Vinci SP platform includes three 6mm arms with two articulation points and an oval-shaped scope, while the Shurui SP uses three 8mm arms with a single articulation point and a 10mm round scope. Although both robots have a similar instrument setup (bipolar on the left, scissors on the right, and a Cadiere in the center), the Shurui SP robot differs in its four-arm structure, hand controls, and instrument articulation. Key procedural steps include accessing the anterior and posterior bladder neck, dissecting the prostate with nerve-sparing techniques, and managing the vascular pedicles with Hem-o-lock clips. The urethra is incised with cold scissors after apical dissection, and the dorsal venous complex (DVC) is sutured with a barbed running suture. Finally, a bidirectional barbed suture is used for posterior reconstruction and anastomosis.
This study underscores the safety and feasibility of both platforms for single-port prostatectomy, with structural differences that do not alter patient positioning, trocar placement, or main surgical steps. Ongoing studies are needed to evaluate and compare the long-term surgical outcomes associated with each platform.
