Posterior Approach for Robot-Assisted Radical Prostatectomy

The posterior trans-peritoneal approach for robot-assisted radical prostatectomy (RARP) in prostate cancer (PCa) patients has been widely adopted over time, where the first minimally invasive radical prostatectomy was performed through a posterior technique. This specific approach allows for easily detecting the vas deferens and seminal vesicles. The larger working space could facilitate their dissection compared to the anterior approach, where, seminal vesicles dissection could be demanding in patients with adverse anatomical features (e.g., large prostate, third lobe, dilated seminal vesicles). However, the evidence is limited regarding the superiority of one approach over the other. Therefore, the choice of the type of approach during RARP is still based on surgeon experience.