Single-Port Robotic Simple Prostatectomy (SP-RASP)By A/Prof Homi Zargar, Urological Surgeon
Introduction
Benign prostatic hyperplasia (BPH) becomes increasingly challenging as prostate size increases. While many enlarged prostates respond well to medications or minimally invasive options such as HoLEP and Bipolar Enucleation (BipoLEP), men with very large glands often require a different strategy.
Single-Port Robotic Simple Prostatectomy (SP-RASP) is an advanced surgical option that allows precise removal of obstructing prostate tissue through a single incision, offering excellent outcomes for men with severe obstruction and very large prostates.
At Western Urology, we are well-positioned to incorporate SP technology into the surgical management of complex BPH.
A Case That Highlights the Value of SP Surgery
We recently assessed a patient with:
Multiple bladder stones
A significantly enlarged prostate (120 cc)
Severe lower urinary tract obstruction
Failure of medical therapy
This is exactly the type of situation where SP robotic surgery offers unique advantages — enabling treatment of both the enlarged prostate and bladder stones in a single, minimally invasive operation.
The SP platform provides enhanced manoeuvrability and precision in confined spaces, making it ideal for complex reconstructive tasks.
What Is Single-Port Robotic Simple Prostatectomy?
Traditional robotic surgery requires multiple small incisions.
Single-Port robotic surgery uses only one small access point, through which:
All robotic instruments
The camera
And articulating tools
are introduced via a single cannula.
This results in:
Less abdominal wall trauma
Reduced postoperative pain
Faster recovery
Minimal scarring
Excellent surgical visibility and control
In SP-RASP, the obstructing adenoma is removed while preserving the outer prostate capsule, restoring urinary flow efficiently.
Benefits of SP-RASP
✔ One small incision
Cosmetically and functionally superior to multi-port or open approaches.
✔ Ideal for very large prostates
SP offers ergonomic advantages in glands over 100 cc.
✔ Excellent access in deep pelvic spaces
Improved articulation and precision.
✔ Ability to clear bladder stones in the same operation
Particularly useful in anatomically complex cases.
✔ Reduced pain and quicker recovery
Less trauma to abdominal musculature.
✔ Significant urinary symptom improvement
Relief from obstruction and restoration of flow.
Who Is Suitable for SP-RASP?
SP-RASP is considered for men with:
Prostates >100–120 cc
Severe urinary symptoms
Bladder stones
Urinary retention
Large intravesical median lobes
Conditions not ideal for HoLEP or BipoLEP
Procedure Overview
SP-RASP generally includes:
One incision for the SP robotic port
Controlled entry into the prostate capsule
Complete enucleation of the adenoma
Removal of bladder stones if present
Reconstruction of the bladder neck
Short postoperative catheterisation
Most patients resume normal activities sooner than with traditional approaches.
How Does SP-RASP Compare With HoLEP and BipoLEP?
Many men will still do extremely well with:
Bipolar Enucleation (BipoLEP) → https://urology-institute.com.au/treatments/bipolep
For comparative reference, the Urology Institute maintains a clear comparison guide:
BPH Treatment Comparison Table → https://urology-institute.com.au/bph-treatment-comparison
However, SP-RASP stands out when:
The prostate is extremely large (>120–150 cc)
Bladder stones need simultaneous management
There is prior surgical scarring
Anatomical complexity is present
A single procedure is preferred
A/Prof Homi Zargar’s Experience
With extensive experience in robotic prostate and kidney surgery, our team continues to integrate next-generation robotic platforms — including Single-Port systems — into complex urological care.
Our early cases show that SP-RASP can be performed safely and effectively with excellent functional outcomes in appropriately selected patients.
Patient-Friendly Resources
A simpler overview of robotic simple prostatectomy is available here:
→ https://urology-institute.com.au/treatments/robotic-simple-prostatectomy
Further information on alternative enucleation techniques:
→ HoLEP: https://urology-institute.com.au/treatments/holep
→ BipoLEP: https://urology-institute.com.au/treatments/bipolep
→ BPH comparison: https://urology-institute.com.au/bph-treatment-comparison
