Retzius-sparing pure laparoscopic radical prostatectomy: initial experience from a single surgeon
- 1Department of Urology, University Clinical Centre of Vojvodina, Novi Sad, Serbia
- 2Pacific Medical Centers, Seattle, Washington, United States
- 3Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
Abstract
INTRODUCTION:: Retzius-sparing radical prostatectomy (RSRP) has gained popularity in robotic surgery due to superior early urinary continence recovery relative to the conventional anterior approach to robot-assisted RP. However, data on pure RS laparoscopic RP (LRP) implementation remain limited. We present our initial experience and early urinary continence outcomes during the implementation phase of RSLRP.
AIM:: The aim of this study was to evaluate early functional and oncological outcomes of RSLRP, with particular emphasis on early continence recovery, and to assess the feasibility of this approach in centers without access to robotic technology.
MATERIALS AND METHODS:: Between August 2024 and October 2025, 7 patients with localized prostate cancer (cT1c–cT2b) underwent RSLRP performed by a single surgeon. Data on perioperative parameters, pathological findings, and early continence outcomes were prospectively collected. Assessment of erectile function was excluded, since the postoperative follow-up period was insufficient.
RESULTS:: All procedures were completed without conversion or blood transfusion. Mean (SD) operative time (from incision to closure) was 242.9 (36.84) minutes, and mean length of hospital stay was 1.86 (0.9) days. Pathological analysis showed locally advanced disease (pT3) in 42.8% of the patients. Positive surgical margins were identified in 57.1% of the cases. Biochemical recurrence occurred in 3 individuals, who received adjuvant radiotherapy and androgen deprivation therapy. All patients achieved urinary continence (completely dry or use of 1 safety-liner pad), with 42.8% achieving continence immediately after surgery, and 100% within 3 months.
CONCLUSIONS:: RSLRP is feasible and can be performed safely during the surgeon’s learning curve. The early rate of continence recovery was encouraging; however, due to the high positive surgical margin rate and short follow-up, oncological outcomes must be interpreted with caution, and larger series with longer follow-up are required.
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BibTeX
@article{grbic2026retziussparing,
title = {{Retzius-sparing pure laparoscopic radical prostatectomy: initial experience from a single surgeon}},
author = {Dragan Grbic and Alexander Cantrell and Djordje Filipovic and Srdjan Govedarica and Aleksandar Grbic and Sasa Vojinov},
journal = {Videosurgery and other Miniinvasive Techniques},
year = {2026},
month = aug,
doi = {10.20452/wiitm.2026.18042},
url = {https://doi.org/10.20452/wiitm.2026.18042},
note = {CC BY-NC-SA 4.0},
}
RIS
TY - JOUR
TI - Retzius-sparing pure laparoscopic radical prostatectomy: initial experience from a single surgeon
AU - Dragan Grbic
AU - Alexander Cantrell
AU - Djordje Filipovic
AU - Srdjan Govedarica
AU - Aleksandar Grbic
AU - Sasa Vojinov
PY - 2026
DA - 2026/08/04
JO - Videosurgery and other Miniinvasive Techniques
DO - 10.20452/wiitm.2026.18042
UR - https://doi.org/10.20452/wiitm.2026.18042
AB - INTRODUCTION:: Retzius-sparing radical prostatectomy (RSRP) has gained popularity in robotic surgery due to superior early urinary continence recovery relative to the conventional anterior approach to robot-assisted RP. However, data on pure RS laparoscopic RP (LRP) implementation remain limited. We present our initial experience and early urinary continence outcomes during the implementation phase of RSLRP. AIM:: The aim of this study was to evaluate early functional and oncological outcomes of RSLRP, with particular emphasis on early continence recovery, and to assess the feasibility of this approach in centers without access to robotic technology. MATERIALS AND METHODS:: Between August 2024 and October 2025, 7 patients with localized prostate cancer (cT1c–cT2b) underwent RSLRP performed by a single surgeon. Data on perioperative parameters, pathological findings, and early continence outcomes were prospectively collected. Assessment of erectile function was excluded, since the postoperative follow-up period was insufficient. RESULTS:: All procedures were completed without conversion or blood transfusion. Mean (SD) operative time (from incision to closure) was 242.9 (36.84) minutes, and mean length of hospital stay was 1.86 (0.9) days. Pathological analysis showed locally advanced disease (pT3) in 42.8% of the patients. Positive surgical margins were identified in 57.1% of the cases. Biochemical recurrence occurred in 3 individuals, who received adjuvant radiotherapy and androgen deprivation therapy. All patients achieved urinary continence (completely dry or use of 1 safety-liner pad), with 42.8% achieving continence immediately after surgery, and 100% within 3 months. CONCLUSIONS:: RSLRP is feasible and can be performed safely during the surgeon’s learning curve. The early rate of continence recovery was encouraging; however, due to the high positive surgical margin rate and short follow-up, oncological outcomes must be interpreted with caution, and larger series with longer follow-up are required.
SN - 1895-4588
SN - 2299-0054
ER -