Objective:To assess the effect of Hood's technique on urinary continence in patients undergoing single-port robot-assisted radical prostatectomy (spRARP).Methods:The clinical data of 53 patients who underwent spRARP performed by a single surgeon in the First Affiliated Hospital of Harbin Medical University from June 2021 to October 2023 were retrospectively analyzed. There were 25 patients in the spRARP+ Hood group and 28 patients in the spRARP group. There were no statistically significant differences between the spRARP+ Hood group and the spRARP group in terms of patients′ age [(70.28±5.98) years vs. (60.89±6.86) years old], body mass index[(24.64±2.85) kg/m 2 vs. (24.59±3.17) kg/m 2], prostate weight [70.00 (40.69, 102.25) g vs. 73.50 (49.13, 94.50) g], total prostate specific antigen[8.62 (4.56, 15.26) ng/ml vs. 12.68 (6.99, 19.24) ng/ml], Gleason score [8 (7, 8) vs. 8 (7, 8)], age-adjusted Charlson comorbidity index (aCCI) [4 (3, 5) vs. 3 (3, 4)], and clinical stage [T 2a/T 2b/T 2c: 6/10/9 cases vs. 5/7/16 cases ] ( P>0.05). In the SpRARP + Hood group, the detrusor apron, tendon arch, pubic prostatic ligament, and dorsal vascular complex were completely preserved during the operation. In contrast, this was not the case for spRARP.Additionally, the incision size, bleeding volume, intraoperative blood transfusion volume, operation time, gastrointestinal function recovery time, total amount of drainage in the first three postoperative days, retention time of the drainage tube, postoperative hospitalization time, positive incision margins, recovery rate of urinary continence immediately after removal of the urinary catheter, and the recovery rate of urinary continence at 1, 3, and 6 months postoperatively were compared between the two groups. Results:All 53 surgeries were successfully completed. The differences in incision length [4.0 (3.5, 4.0) cm vs. 4.0 (4.0, 4.0) cm], intraoperative bleeding [50 (40, 100) ml vs. 100 (50, 100) ml], and intraoperative transfusion rate [4.0% (1/25) vs. 17.8% (5/28)] were not statistically significant between the spRARP+ Hood group and the spRARP group ( P>0.05), and the difference in operative time [205.0 (167.5, 240.0) min vs. 242.5 (185.0, 300.0) min] was statistically significant( P<0.05).The recovery time of gastrointestinal function in the spRARP+ Hood group vs. the spRARP group [1.0 (1.0, 1.5) d vs. 1.0 (1.0, 2.0) d], total amount of drainage in the first 3 d postoperatively [150.00 (72.50, 261.00) ml vs. 230.00 (115.00, 417.50) ml], duration of drain retention [5.0 ( 4.0, 5.0) d vs. 5.0 (4.0, 6.8) d], postoperative hospital stay [5.0 (4.0, 7.5) d vs. 5.0 (3.3, 7.8) d], and margin positivity rate [4.0% (1/25) vs. 3.6% (1/28)] were not statistically significant ( P>0.05). The postoperative Clavien-Dindo complication classification was grade I in both groups. The differences between the spRARP+ Hood group and the spRARP group in the rates of recovery of urinary continence immediately after the urinary catheter removal [56.0% (14/25) vs. 7.1% (2/28)] and one month after surgery [76.0% (19/25) vs. 28.5% (8/28)] were statistically significant ( P<0.05). The differences in the rates of recovery of urinary continence at 3 months after surgery [80.0% (20/25) vs. 67.8% (19/28)], at 6 months after surgery [88.0% (22/25) vs. 96.4% (27/28)], and biochemical recurrence at 6 months after surgery [4.0% (1/25) vs. 3.6% (1/28)] were not statistically significant ( P>0.05). Conclusions:The outcomes of spRARP+ Hood in the treatment of localized prostate cancer were comparable to those of spRARP. However, spRARP+ Hood has better urinary continence immediately after removal of the urinary catheter and 1 month postoperatively.

Objective:To assess the effect of Hood's technique on urinary continence in patients undergoing single-port robot-assisted radical prostatectomy (spRARP).Methods:The clinical data of 53 patients who underwent spRARP performed by a single surgeon in the First Affiliated Hospital of Harbin Medical University from June 2021 to October 2023 were retrospectively analyzed. There were 25 patients in the spRARP+ Hood group and 28 patients in the spRARP group. There were no statistically significant differences between the spRARP+ Hood group and the spRARP group in terms of patients′ age [(70.28±5.98) years vs. (60.89±6.86) years old], body mass index[(24.64±2.85) kg/m 2 vs. (24.59±3.17) kg/m 2], prostate weight [70.00 (40.69, 102.25) g vs. 73.50 (49.13, 94.50) g], total prostate specific antigen[8.62 (4.56, 15.26) ng/ml vs. 12.68 (6.99, 19.24) ng/ml], Gleason score [8 (7, 8) vs. 8 (7, 8)], age-adjusted Charlson comorbidity index (aCCI) [4 (3, 5) vs. 3 (3, 4)], and clinical stage [T 2a/T 2b/T 2c: 6/10/9 cases vs. 5/7/16 cases ] ( P>0.05). In the SpRARP + Hood group, the detrusor apron, tendon arch, pubic prostatic ligament, and dorsal vascular complex were completely preserved during the operation. In contrast, this was not the case for spRARP.Additionally, the incision size, bleeding volume, intraoperative blood transfusion volume, operation time, gastrointestinal function recovery time, total amount of drainage in the first three postoperative days, retention time of the drainage tube, postoperative hospitalization time, positive incision margins, recovery rate of urinary continence immediately after removal of the urinary catheter, and the recovery rate of urinary continence at 1, 3, and 6 months postoperatively were compared between the two groups. Results:All 53 surgeries were successfully completed. The differences in incision length [4.0 (3.5, 4.0) cm vs. 4.0 (4.0, 4.0) cm], intraoperative bleeding [50 (40, 100) ml vs. 100 (50, 100) ml], and intraoperative transfusion rate [4.0% (1/25) vs. 17.8% (5/28)] were not statistically significant between the spRARP+ Hood group and the spRARP group ( P>0.05), and the difference in operative time [205.0 (167.5, 240.0) min vs. 242.5 (185.0, 300.0) min] was statistically significant( P<0.05).The recovery time of gastrointestinal function in the spRARP+ Hood group vs. the spRARP group [1.0 (1.0, 1.5) d vs. 1.0 (1.0, 2.0) d], total amount of drainage in the first 3 d postoperatively [150.00 (72.50, 261.00) ml vs. 230.00 (115.00, 417.50) ml], duration of drain retention [5.0 ( 4.0, 5.0) d vs. 5.0 (4.0, 6.8) d], postoperative hospital stay [5.0 (4.0, 7.5) d vs. 5.0 (3.3, 7.8) d], and margin positivity rate [4.0% (1/25) vs. 3.6% (1/28)] were not statistically significant ( P>0.05). The postoperative Clavien-Dindo complication classification was grade I in both groups. The differences between the spRARP+ Hood group and the spRARP group in the rates of recovery of urinary continence immediately after the urinary catheter removal [56.0% (14/25) vs. 7.1% (2/28)] and one month after surgery [76.0% (19/25) vs. 28.5% (8/28)] were statistically significant ( P<0.05). The differences in the rates of recovery of urinary continence at 3 months after surgery [80.0% (20/25) vs. 67.8% (19/28)], at 6 months after surgery [88.0% (22/25) vs. 96.4% (27/28)], and biochemical recurrence at 6 months after surgery [4.0% (1/25) vs. 3.6% (1/28)] were not statistically significant ( P>0.05). Conclusions:The outcomes of spRARP+ Hood in the treatment of localized prostate cancer were comparable to those of spRARP. However, spRARP+ Hood has better urinary continence immediately after removal of the urinary catheter and 1 month postoperatively.

Objective To evaluate the feasibitity of robot-assisted posterior laparoscopic modified"single-position"radical nephroureterectomy.Methods A retrospective analysis was made on 7 patients receiving robot-assisted posterior laparoscopic single-position radical nephroureterectomy between April 2022 and April 2023.The patients were in a fully healthy lateral position,and an artificial pneumoperitoneum was established.Trocars were placed at the right costal margin of the posterior axillary line,3-4 cm above the iliac crest of the midaxillary line,6-8 cm below the anterior axillary line,and 3-4 cm above the iliac crest of the midaxillary line near the outer edge of the musculus rectus abdominis,respectively.After the kidney was removed,the ureter was freed down to the iliac vessels,and then the main joint of the robot was reversed 180° for redocking.The ureter was continuously freed downwards to the bladder wall and the catheter was clamped.The bladder was opened after filling with indocyanine green and distilled water mixture.Then the fluid in the bladder was washed,the contralateral ureteral orifice was observed,the affected side of the ureter was resected,and the bladder incision was sutured by two layers with V-LOCK 2-0 sutures.The incision was extended under the right costal margin of the posterior axillary line and 3-4 cm above the iliac crest of the midaxillary line to remove the specimen.Results The operation was successfully completed in all the 7 cases.The surgical operation time was 155-263 min(mean,247.0 min)and the blood loss was 20-100 ml(mean,42.9 ml).The postoperative anal exhaust time was 14-24 h(mean,22.6 h).There were 1 case of postoperative absorption fever,2 cases of moderate anemia,and 2 cases of postoperative incision fat liquefaction.In the 2 patients with moderate anemia,one patient developed postoperative intramuscular artery rupture leading to massive bleeding and the formation of hematoma in the surgical area,with the amount of bleeding being approximately 1000 ml,and the other had moderate anemia before and after surgery.The hospital stay ranged 8-16 d(mean,11.6 d).Pathologic examinations showed high-grade uroepithelial carcer in all the patients.Postoperative follow-ups lasted 3-9 months,with a mean of 6.2 months.None had bladder tumor recurrence or distant metastasis.Conclusion Robot-assisted posterior laparoscopic modified"single-position"radical nephroureterectomy is safe and feasible.