Extraperitoneal robot-assisted simple prostatectomy (Millin) on the da Vinci Xi: Step by-step surgical technique

Objectives

To describe an extraperitoneal robotic Millin simple prostatectomy technique using the da Vinci Xi platform and report perioperative and 12-month functional outcomes in men with large benign prostatic hyperplasia (BPH). Patients and surgical procedure: Prospective single-center series of 22 consecutive men (October 2022–March 2025) with symptomatic BPH and prostate volume ≥80 cc undergoing extraperitoneal robot-assisted Millin simple prostatectomy. Perioperative and functional outcomes were recorded. Preoperative versus 12-month International Prostate Symptom Score (IPSS) and maximum urinary flow rate (Qmax) were compared using paired Wilcoxon signed-rank tests. Postoperative day 0–90 complications were graded by Clavien–Dindo.