The re-discovery of alternative access to the pelvic fossa: the role of the single-port robotic platform

With the aim of minimizing the patient’s postoperative pain, expediting recovery and improving cosmesis, the idea of performing a laparoscopic procedure through a single abdominal incision was introduced. In this chapter, five different access routes to the pelvic fossa are described that may be at the surgeon’s disposal with the potential of decreasing patient’s perioperative morbidity. Specifically, robotic radical prostatectomy has been refined and became a standard of care in surgery for localized prostate cancer. The advent of a single-port dedicated robotic platform has prompted the re-discovery of different access routes to the prostate and ideally all of them are nowadays feasible. The potential for avoiding the abdominal cavity does decrease the surgical morbidity and minimize the surgical dissection. Each of the described approaches could be chosen on the basis of the patient’s preoperative comorbidities, body habitus, anatomy, and disease characteristics and location.