Scarless Transumbilical Radical Prostatectomy

In this video, we describe a modification of the single-port laparoscopic radical prostatectomy, using a transumbilical tri-channel reusable port (KeyPort; Richard Wolf GmbH, Knittlingen, Germany), plus a second 5mm port placed in the left iliac fossa with the aim of having an adequate working angle during the most critical steps of the procedure. The KeyPort system incorporates a conceptual change, where the individual instruments are moved to a dual-rotation system of arms that avoids both external clashing and internal crossing by a combination of the curved nature of the instruments and the articulated rotation of their tip without rigidity loss. This minimally invasive technique is a safe procedure and appears to be a good compromise between a pure single multichannel port and a standard multitrocar laparoscopic approach. This represents a step forward to reduce invasiveness of laparoscopic surgery, and much more cost effective than its robotic counterpart.