Single-port (SP) robotic transvesical bladder diverticulectomy: Description of technique and initial outcomes

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INTRODUCTION We aim to present our robotic transvesical (TV) technique for performing bladder diverticulectomy using the da Vinci single-port (SP) surgical platform. METHODS We performed three cases of SP robotic TV diverticulectomy between 2020-2023. The TV surgical technique described in the video pertained to a 66-year-old male with severe lower urinary tract symptoms (LUTS) secondary to benign prostate hypertrophy (BPH). Given the large posterior bladder diverticulum identified on preoperative magnetic resonance imaging (MRI), diverticulectomy was performed in the same intraoperative setting for SP TV enucleation of the prostate (STEP) through the same bladder incision. RESULTS All SP TV bladder diverticulectomy cases were completed without any complications, conversion to other approaches, or additional ports. All patients were discharged on the same day (median stay of 4 hours), and no postoperative complications were seen. All subjects had an improvement in their postoperative international prostatism symptom scores (IPSS) at a median follow-up of 16 months. CONCLUSION SP TV robotic diverticulectomy is a feasible option for the excision of the bladder diverticula. The TV approach offers the benefit of regionalizing the surgery to the bladder, simultaneous treatment of bladder and prostate pathology, and overall shorter foley catheter duration.

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