Background: Some reports in the literature describe
lymphocele formation in as much as half of patients after pelvic
lymph node dissection (PLND) in robot-assisted radical
prostatectomy (RARP), with 1%-2% requiring intervention. Several treatment modalities for symptomatic
lymphoceles are available, including percutaneous drainage,
sclerosing agents, and surgical marsupialization, typically performed by laparoscopy or with a multiport robotic platform. The advantage of surgical approach is permanent excision of the
lymphocele capsule and fewer days with pelvic drains compared to percutaneous drainage. This study aims to describe and illustrate, for the first time, the step-by-step surgical management of symptomatic
lymphoceles using a less invasive robotic platform, the da Vinci® Single Port (SP). Materials and Methods: We describe the outcomes of three patients who underwent lymphocelectomy and marsupialization with the da Vinci SP for symptomatic
lymphoceles after RARP and PLND with the da Vinci Xi. Results:
Operative time for cases 1, 2, and 3 was 84, 80, and 79 minutes. The blood loss for each surgery was 25 mL. Patient 2 was discharged in 3 days, whereas patients 1 and 3 were discharged in 4 days. No intraoperative or postoperative complications were reported. All patients had their drain removed in under 24 hours after surgery. The mean follow-up period was 7.7 months (3.5-15.8). No patients were readmitted or had
lymphocele recurrence. Conclusion: Da Vinci SP lymphocelectomy is safe and feasible with satisfactory outcomes. The SP enables definitive treatment of the
lymphocele sac, reducing the number of days with abdominal drains, and allows further decrease in surgical invasiveness with fewer incisions and better cosmesis.