LAUSR

Some reports in the literature describe lymphocele formation in up to half of patients following pelvic lymph node dissection (PLND) in robotic-assisted radical prostatectomy (RARP), with 1-2% requiring intervention. Several treatment modalities for symptomatic lymphoceles are available, including percutaneous drainage, sclerosing agents, and surgical marsupialization, typically performed by laparoscopy or with a multiport robotic platform. The advantage of surgical approach is permanent excision of the lymphocele capsule and fewer days with pelvic drains compared to percutaneous drainage. This study aims to describe and illustrate, for the first time, the step-by-step surgical management of symptomatic lymphoceles using a less invasive robotic platform, the da Vinci® Single Port (SP). Material and methods We describe, for the first time in the literature, the outcomes of three patients who underwent lymphocelectomy and marsupialization with the da Vinci® SP for symptomatic lymphoceles following RARP and PLND with the da Vinci® Xi. Results Operative time for cases 1, 2, and 3 was 84, 80, and 79 minutes. The blood loss for each surgery was 25 ml. Patient 2 was discharged in 3 days, while patients 1 and 3 were discharged in 4 days. No intra- or post-operative complications were reported. All patients had their drain removed in under 24 hours after surgery. The mean follow-up period was 7.7 months (3.5-15.8). No patients were readmitted or had lymphocele recurrence. Conclusion Da Vinci® SP lymphocelectomy is safe and feasible with satisfactory outcomes. The SP enables definitive treatment of the lymphocele sac, reducing the number of days with abdominal drains and allows further decrease in surgical invasiveness with fewer incisions and better cosmesis.