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The evolution and resurgence of perineal prostatectomy in the robotic surgical era



To review the recent advances in terms of surgical technique and new robotic platforms applied to radical perineal prostatectomy (RPP).


A literature review was performed focusing on original articles on perineal prostatectomy searching via Medline/Pubmed and Embase. The entire spectrum was covered such as development of surgical technique including pelvic lymphadenectomy, adoption of novel surgical platforms, learning curve and future directions.


Surgical removal of the prostate plays a significant role on the treatment of localized prostate cancer (PCa). RPP was the first surgical approach described for radical prostatectomy. This technique declined in popularity secondary to the development of the retropubic approach. Recently, the appearance of novel robotic technology has generated renewed interest in the perineal approach.


There has been a recent resurgence on the interest of radical perineal prostatectomy for the treatment of localized PCa driven by the advent of new robotic surgical technologies into the field. Future studies are needed to better determine the learning curve of the perineal approach and its current role in the treatment of prostate cancer.

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Author information

JDG: project development, data collection, and manuscript writing. RB: data collection and manuscript writing. CAW: manuscript writing. JK: critical revision of the manuscript for important intellectual content.

Correspondence to Jihad Kaouk.

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Jihad Kaouk certifies that all conflict of interest, including specific financial interest and relationships and affiliations relevant to the subject matter or materials discussed in the manuscript (e.g., employment/affiliation, grants or funding, consultancies, honoraria, stock ownership or options, expert testimony, royalties or patents filed, received or pending), are the following: Jihad Kaouk is consulting research for Intuitive Surgical. The rest of the authors (Juan Garisto, Riccardo Bertolo, and Clark A. Wilson) have nothing to disclose.

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Garisto, J., Bertolo, R., Wilson, C.A. et al. The evolution and resurgence of perineal prostatectomy in the robotic surgical era. World J Urol (2019). https://doi.org/10.1007/s00345-019-03004-1

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  • Robotic
  • Perineal prostatectomy
  • Prostate cancer
  • Single port