The learning curve of single‐port extraperitoneal robotic radical prostatectomy: Initial experience and outcomes from a newly graduated fellowship‐trained robotic surgeon

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Authors: Jacob Hershenhouse, S. Kim, Rafael Gevorkyan, Brian Hom, Michael Eppler, Patrick Ford, Ram Pathak, Riccardo Autorino, Andre Luis Abreu, Ketan K. Badani, Simone Crivellaro, Sij Hemal
Cited by: 2
References: 22

Abstract

Introduction and Objective: This study aims to evaluate the learning curve and perioperative outcomes of single-port extraperitoneal robotic radical prostatectomy (SP-EP-RARP) performed by a single surgeon at a high-volume academic institution. Methods: A retrospective review of a prospectively maintained database was conducted for patients who underwent SP-EP-RARP from September 2023 to August 2025. Key metrics included operative time, estimated blood loss, conversion rate, nerve-sparing status, pathological margin status and continence (0-1 pad for safety), and 30-day complication rate. Descriptive statistics were used, and outcomes were analysed chronologically to assess for trends suggesting a learning curve. Results: one ports were utilized. Final pathology revealed pT2 disease in 64.1% (34 cases), pT3a in 32.1% (17 cases) and pT3b in 3.7% (2 cases). Overall positive margin rate was 26.4%. Thirty-day Clavien-Dindo Grades I-II complication rates were 11.3%, and no major complications or 90-day complications were reported. Continence rates at 6 weeks, 3 months and 6 months were 72%, 72% and 75%, respectively. Stabilization of operative times and intraoperative outcomes occurred after approximately 25-30 cases. Conclusion: SP-EP-RARP can be safely implemented by a newly graduated fellowship-trained robotic surgeon with acceptable oncologic and functional outcomes. Initial learning can be estimated at approximately 25-30 cases.

Fields of Study & Subjects

Prostate Cancer Diagnosis and Treatment Minimally Invasive Surgical Techniques Intraoperative Neuromonitoring and Anesthetic Effects

Publication details

Journal / source
BJUI Compass
Publisher
Wiley
Volume
7
Issue
3
Pages
e70184–e70184
Publication date
1 March 2026
Language
EN