International Delphi consensus on single-port robotic radical prostatectomy: patient selection, surgical technique, and training.
Document Type
Article
Publication Date
6-15-2026
Publication Title
BJU international
Abstract
INTRODUCTION: The introduction of the purpose-built single-port (SP) robotic platform has allowed for the advent of regionalized minimally invasive surgical approaches for robotic radical prostatectomy (RARP), including the extraperitoneal and transvesical techniques. This study sought to develop a best practice consensus on the key principles, patient selection, surgical techniques, expected clinical outcomes, and learning curves pertaining to SP-RARP.
METHODS: A modified Delphi consensus was developed by a panel of experts, consisting of a 33-item questionnaire, with each statement rated using a binary Likert scale ('agree' or 'disagree'). The survey was distributed via email to all practicing SP-RARP surgeons across the USA and Europe. Consensus was defined as ≥75% agreement on a given statement.
RESULTS: A total of 53 surgeons participated in the Delphi Consensus across the two rounds. Of 33 statements, 28 (84.8%) reached agreement in the first round. The remaining consensus was achieved in the second round, involving 35 surgeons, and with one additional statement. The panel agreed that, although are no absolute contraindications to SP-RARP, the preference towards specific SP-RARP techniques should remain guided by the individual patients and surgical expertise. Although the SP extraperitoneal technique is recommended to pursue pelvic lymph node dissections, the panel agreed that transvesical SP-RARP showed promise in promoting shorter hospital stay, faster recovery of urinary continence, and utility in patients with extensive prior abdominal surgery. Consensus was also reached on the need for a structured training pathway, with most recommending beginning with extraperitoneal SP-RARP before advancing to the transvesical approach.
CONCLUSION: This Delphi consensus demonstrates broad agreement among experienced SP surgeons in the USA and Europe, forming the foundation for future research on the clinical utility and necessary training pathways for SP-RARP. Nevertheless, empirical validation based on clinical data from large cohort studies remains important.
Recommended Citation
Soputro NA, Rais-Bahrami S, Bjurlin M, Srivastava A, Umbreit E, Eltemamy M et al [Shetty International delphi consensus on single-port robotic radical prostatectomy: patient selection, surgical technique, and training. BJU Int. 2026 Jun 15. doi: 10.1111/bju.70346. Epub ahead of print. PMID: 42297464.
DOI
10.1111/bju.70346
ISSN
1464-410X
PubMed ID
42297464