Typical pathway (radical prostatectomy)
In Dr Kooner's SP robotic prostatectomy practice, patients are usually admitted on the day of surgery, stay in hospital for 1 to 2 days, and go home with a urinary catheter that is usually removed at follow-up around day 6 to 7. The paragraphs below also describe themes from the published comparative evidence base.
Length of stay
Most men go home 1 to 2 days after surgery, on average shorter than MP-RARP in comparative series; in one high-volume series 88% of SP patients were discharged the same day versus 55% for MP.1,8
Catheter
A urinary catheter is left in place while the anastomosis heals. In Dr Kooner's practice it is usually removed around day 6 to 7 at a follow-up visit; published series have typically reported removal between day 7 and day 10.2
Pain
Lower pain scores and lower opioid requirement than MP-RARP in comparative studies (a small but consistent effect, SMD 0.12 in the 2025 meta-analysis); most men manage on paracetamol and a short course of anti-inflammatories.1,4
Wound care
One small suprapubic incision to heal, with sutures usually dissolvable. A waterproof dressing allows showering within a day or two.
Return to activity
Walking from the day of surgery. Desk-type work usually 2 to 3 weeks. Avoid heavy lifting (over 5 kg), cycling and strenuous exercise for approximately 4 weeks while the deep layers heal.
Continence and erectile function
Pelvic floor exercises are started early to shorten the period of transient stress incontinence, which is expected in the first weeks after any radical prostatectomy. Recovery of erectile function, where nerve-sparing has been possible, typically occurs over 3 to 18 months and is supported by early rehabilitation with PDE5 inhibitors where appropriate. Published SP vs MP comparisons show no significant difference in continence or potency recovery at current follow-up.1,2
Risks and complications (overview)
Every patient is counselled before surgery. The risks of SP robotic prostatectomy are the risks of any radical prostatectomy; published comparative data show no increase in major complication (Clavien-Dindo) rates over multiport RARP.1,2 These include bleeding, injury to adjacent structures, anastomotic leak or stricture, urinary incontinence, erectile dysfunction, cancer control issues, slightly longer operative time early in a surgeon's SP experience, conversion to multiport or open surgery, and venous thromboembolism. Full discussion is part of the consent process.
Frequently asked questions
Is SP better than multiport robotic surgery?
Not "better" in every respect. The published comparative evidence shows that SP is associated with less blood loss, a small reduction in post-operative pain, and a shorter hospital stay, while achieving comparable cancer-control and continence/potency outcomes at current follow-up.1,2 There are no randomised trials, and long-term (over five years) cancer outcomes for SP are still accumulating. The right approach depends on the individual cancer, the anatomy, and the patient's priorities.
Is there more risk because it is a newer technique?
The da Vinci SP platform has been cleared for urologic use in the United States since 31 May 2018 (FDA 510(k) K173906).11 Published comparative series do not show an increase in major complication rates compared with the well-established multiport approach, provided the surgeon has completed structured training and an early-case mentorship, which is the pathway Dr Kooner has followed.1,2,25
Will I have a scar?
There is one incision, usually 3 to 3.5 cm, placed low on the abdomen so it is normally hidden below the waistband.13 It replaces the four to six small port scars left by a multiport operation.
How long before I can drive and return to work?
Most men feel well enough to resume light daily activity within a few days, drive within 1 to 2 weeks, and return to office-based work in a similar timeframe. Heavy lifting, cycling and strenuous exercise are typically deferred for approximately 4 weeks.
Can any patient have SP surgery?
No. Suitability depends on the tumour, the anatomy, prior abdominal surgery, body habitus and co-existing medical conditions. In some cases a multiport robotic or open operation is the better choice, and this is discussed at consultation.1,2