Robotic prostate surgery is usually performed through several small keyhole incisions in the abdomen rather than a single large cut. A standard multi-port robotic prostatectomy commonly uses five or six small abdominal incisions. The exact number and position can vary according to the robotic platform, surgical approach, your anatomy and your surgeon’s planned port arrangement.
These incisions allow your surgeon to place a high-definition camera, robotic instruments, and assistant ports into the abdomen. Each port has a specific purpose during the operation, helping your surgical team access and remove the prostate safely. The small openings also allow the procedure to be performed deep within the pelvis without the need for traditional open surgery.
For you, the incisions are often the most visible sign of surgery during the early stages of recovery. Understanding why they are needed, where they are usually positioned, and how they typically heal can make the process feel less unfamiliar. Knowing what to expect before your operation may also help you feel more confident and prepared.
Why Robotic Prostate Surgery Uses Small Incisions
Robotic prostate surgery is a form of minimally invasive keyhole surgery. Instead of making one long incision in your abdomen, your surgeon performs the operation through several small openings. This approach allows access to the prostate while reducing the need for a large surgical wound.
These small openings are used to place narrow tubes known as ports. The camera and robotic instruments pass through these ports, allowing your surgeon to operate deep within the pelvis with a magnified view of the surgical area. This helps support precision throughout the procedure.
The goal is to remove the prostate safely while minimising the size of the incisions needed to perform the operation. Robotic surgery usually produces several smaller scars rather than one longer abdominal scar. Some studies have reported early recovery advantages compared with open surgery, but wound discomfort and healing vary between individuals.
The Typical Number of Incisions
In standard multi-port robotic prostate surgery, you will typically have five or six small incisions in the abdomen. These are usually needed for the camera port, several robotic instrument ports, and one or more assistant ports used during the procedure. Each incision has a specific role in helping your surgeon perform the operation safely.
The exact number of incisions can vary from one patient to another. Your surgeon may adjust the port arrangement according to your body shape, previous abdominal surgery, the robotic platform and the chosen surgical route. Lymph-node dissection is usually performed through the existing ports, although the overall plan can vary between surgical teams.
For this reason, it is more helpful to think of five or six incisions as a typical range rather than a fixed number. Your surgical team can explain what they expect in your individual case and why the planned arrangement is most appropriate for you.
Incisions and Ports in Robotic Prostate Surgery
| Port or Site | Main Purpose | Usual Position | Important Point |
| Camera port | Provides access for the robotic camera | Commonly near the central abdomen or belly button area | Provides the surgeon with a magnified view of the pelvis |
| Robotic instrument ports | Allow the robotic instruments to dissect, grasp, seal and suture tissue | Arranged across the left and right sides of the abdomen | Several ports are needed so the instruments can work together without colliding |
| Assistant port | Allows the bedside assistant to use suction, pass clips or sutures and assist with specimen handling | Position varies according to the platform and surgeon | Some operations use one assistant port, while others may use more than one |
| Specimen retrieval site | Allows the prostate and seminal vesicles to be removed in a retrieval bag | Usually an existing port site | The incision is commonly enlarged slightly rather than creating a completely separate wound |
| Drain exit site, when used | Allows a temporary pelvic drain to leave the body | Often through an existing port site | A drain is not required for every patient and is commonly brought out through an existing port site when used |
| Occasional additional port | Provides extra access where clinically required | Varies | It is not routinely needed solely because lymph nodes are being removed |
Evidence Note: Does Having Fewer Incisions Improve Outcomes?
The current BAUS patient leaflet states that a conventional robotic-assisted radical prostatectomy normally uses five or six keyhole abdominal incisions. These allow the robotic instruments to free the prostate from the bladder and urethra before urinary reconstruction is completed.
A 2025 systematic review included 21 studies and 1,400 patients, although three studies concerned simple rather than radical prostatectomy. Eight comparative studies were included in the pooled analysis. Single-port and multi-port radical prostatectomy had broadly similar short-term perioperative, functional and oncological outcomes, but most evidence was retrospective and follow-up was limited.
The review found no clear overall differences in complications, continence, potency, surgical margins or biochemical recurrence. Differences in pain, catheter duration and hospital stay were inconsistent across analyses. Hospital stay was shorter with single-port surgery in one sensitivity analysis, but the authors emphasised that most studies were retrospective and follow-up was limited.
For you, this means that fewer skin incisions may alter scar appearance and early wound experience, but the number of incisions alone does not determine the safety, cancer control or functional success of prostate surgery.
Why You May Have More Than One Incision
Each incision made during robotic prostate surgery has a specific purpose. One port is usually used for the camera, while the others allow the robotic instruments to dissect, hold, cut, seal, and stitch tissue. Together, these ports give your surgeon the access needed to perform the operation safely.
You may also have an assistant port that allows the bedside assistant to pass sutures, clips, suction devices, or other instruments during the procedure. Although your surgeon controls the robotic instruments, robotic prostate surgery remains a team effort. The assistant plays an important role throughout the operation.
At the end of the procedure, one incision may be made slightly larger to allow the prostate specimen to be removed. This is a normal part of the surgery and is planned in advance. For you, a slightly larger incision does not necessarily indicate a complication or that anything unexpected occurred during the operation.
Where the Incisions Are Usually Made
In a standard multi-port operation, the incisions are generally arranged across the central and lower abdomen. Some may be close to or above the belly button, while others are positioned on the left and right sides.
The arrangement of the incisions often follows a slightly curved pattern across the abdomen. Your surgeon places the ports carefully so the robotic instruments can reach the prostate safely and move freely during the operation. Proper positioning helps ensure that the instruments work efficiently without interfering with one another.
The exact location of the incisions can vary from one patient to another. Factors such as your body shape, abdominal wall thickness, previous surgical scars, and the chosen surgical approach may all influence where the ports are placed. Your surgeon will select the positions that are most appropriate for your individual anatomy.
Why Port Placement Matters
Port placement is a carefully planned part of robotic prostate surgery. Your surgeon needs enough space between the ports to allow the robotic arms to move freely and safely during the operation. The position of each port is selected to provide appropriate access to the prostate while allowing the instruments to move without interfering with one another.
If the ports are placed too close together, the robotic instruments can become more difficult to manoeuvre. Poor positioning may also make it harder to reach deep areas of the pelvis efficiently. Careful planning helps reduce instrument interference and supports safe access to the surgical area.
Good port placement allows your surgeon to work with greater precision throughout the operation. It also helps maintain a clear view of important structures, including the prostate, bladder, blood vessels, nerves, and surrounding tissues. Careful port placement helps the surgeon achieve appropriate access and instrument movement. Overall safety and outcomes also depend on your anatomy, cancer characteristics, surgical technique and the experience of the whole team.
What Is a Camera Port?
The camera port is the opening used to insert the robotic camera during surgery. This camera provides your surgeon with a magnified three-dimensional view of the abdomen and pelvis. The detailed visualisation helps important anatomical structures be seen more clearly throughout the procedure.
The camera is one of the main reasons robotic prostate surgery can be performed through small incisions. It allows your surgeon to view the surgical area in great detail without needing a large open incision. This enhanced visibility supports precision during each stage of the operation.
The camera port is often positioned near the centre of your abdomen, although the exact location can vary. Your surgeon selects the most suitable position based on your anatomy and the planned surgical approach. Careful placement helps provide an appropriate view of the prostate and surrounding structures.
What Are Robotic Instrument Ports?
Robotic instrument ports are the small openings that allow the robotic arms to place surgical instruments inside your body. These instruments are used to cut, grasp, dissect, stitch, and control bleeding during the operation. Each port provides access to a specific area of the surgical field.
Your surgeon controls these instruments from a specialised console throughout the procedure. The robotic system does not make decisions or operate independently. Instead, it precisely follows your surgeon’s movements and instructions in real time.
Although the ports are small, they play a vital role in robotic prostate surgery. Without them, your surgeon would not be able to perform the delicate steps needed to remove the prostate and reconnect the bladder to the urethra. For you, these ports are an important part of making minimally invasive surgery possible.
What Is an Assistant Port?
An assistant port is a small opening that allows another member of the surgical team to assist during the operation. While your surgeon controls the robotic instruments from the console, the assistant remains beside you at the operating table. This helps ensure the procedure runs efficiently and safely.
Through the assistant port, the surgical assistant may pass sutures, remove small pieces of tissue, use suction, apply clips, or help with specimen handling. These tasks support your surgeon during different stages of the operation. Robotic prostate surgery relies on teamwork as well as surgical technology.
The number and size of assistant ports can vary between procedures. Your surgeon may use a different port arrangement depending on their preferred technique and the complexity of your case. For you, this means the exact incision pattern may differ slightly from that of another patient.
Why One Incision May Be Slightly Larger
At the end of the operation, your prostate and seminal vesicles need to be removed from the body. They are usually placed inside a specialised specimen retrieval bag and taken out through one of the abdominal incisions. This allows the tissue to be removed safely without creating a large surgical wound.
Because the prostate is larger than the surgical instruments used during the procedure, one incision may need to be extended slightly. This is often the incision that appears more noticeable when you look at your wounds after surgery. The enlargement is planned and forms a normal part of the operation.
Although this incision is slightly larger than the other port sites, it is still much smaller than the incision used in traditional open surgery. You may find that it feels more tender during the early stages of recovery. However, this discomfort usually improves as healing progresses.
How Robotic Incisions Differ from Open Surgery
Open prostate surgery usually involves one larger incision in the lower abdomen, while robotic surgery uses several smaller keyhole incisions. This difference changes how your surgeon accesses the prostate and may influence your early recovery.
- Smaller keyhole incisions: Robotic surgery uses several small cuts across the abdomen rather than one larger opening.
- Access through specialised ports: A camera and robotic instruments are inserted through small ports to reach the prostate.
- Different abdominal access: Robotic surgery reaches the pelvis through several keyhole ports rather than one longer open incision.
- Different wound appearance: Robotic incisions usually leave several smaller scars instead of one longer abdominal scar.
- Possible early recovery benefits: Smaller incisions may help reduce wound discomfort during the first stages of recovery.
Both open and robotic prostatectomy are major surgical procedures, even though the incisions are different. Whichever approach is used, you will still need careful recovery, follow-up appointments and guidance from your surgical team.
Are the Incisions Painful?
You can expect some soreness and discomfort around the incisions after robotic prostate surgery. The discomfort is often most noticeable when you move, cough, stand up from a chair, or use your abdominal muscles. This is a normal part of the healing process during the early recovery period.
Many men find that incision-related discomfort can be managed with regular pain relief. Your medical team will advise you on the most appropriate medications and how to use them safely. Following their advice can help you stay comfortable while you recover.
The pain should gradually improve as your wounds heal. However, you should seek medical advice if you notice a sudden increase in pain, fever, spreading redness, vomiting, or significant abdominal swelling. These symptoms may indicate a problem that needs prompt assessment.
Will the Incisions Be Stitched?
Your incisions may be closed using dissolvable stitches, skin glue, clips, or small dressings. The method used will depend on your surgeon’s preference and your hospital’s protocol. Each approach is designed to support wound healing and protect the incision sites.
Some types of wound closure do not require any removal because they dissolve or fall away naturally. Others may need a nurse or doctor to remove clips, stitches, or dressings during a follow-up appointment. Your discharge information should explain exactly what applies to your situation.
You should avoid picking at glue, scabs, or dressings while your wounds are healing. Allowing the area to heal naturally can help reduce irritation and support recovery. If you are unsure about wound care, your medical team can advise you on when dressings can be removed and when the incisions can be left uncovered.
What the Incisions Look Like After Surgery
Immediately after surgery, your incision sites may appear red, bruised, or slightly swollen. You might also notice small amounts of dried blood or marks left by dressings. These changes are common during the early stages of healing.
The appearance of the wounds can sometimes be surprising, especially if you were expecting only tiny marks. Although the incisions are small, they still pass through the skin and abdominal wall, so some bruising, swelling, and tenderness are normal. These effects usually improve over the first few weeks after surgery.
As your recovery progresses, the incisions generally become less noticeable. The scars often fade gradually over time, although the final appearance can vary from person to person. Factors such as your skin type, healing response, and wound care may all influence how the scars eventually look.
Why Bruising Can Happen
Bruising around the incisions is common after robotic prostate surgery. It can occur because small blood vessels are affected when the ports are inserted and instruments are moved during the operation. You may notice the bruising spread slightly before it gradually starts to fade.
Some men also develop bruising that extends towards the groin or scrotum. This can happen because fluid and blood from the surgical area may move downwards with gravity during the recovery period. Although it can look concerning, this type of bruising is often expected after pelvic surgery.
For you, mild bruising is usually a normal part of healing. However, heavy bleeding, rapidly increasing swelling, or severe pain should be assessed by a medical professional. If you are unsure whether something is normal, it is always sensible to contact your surgical team for advice.
Why Swelling Can Happen
Some swelling around your incision sites is expected after robotic prostate surgery. During the operation, tissues are handled, stretched, and repaired, so a mild inflammatory response is a normal part of the healing process. This swelling usually settles gradually as your recovery progresses.
You may also notice a bloated feeling in your abdomen after surgery. This can occur because carbon dioxide gas is used during the procedure to create working space inside the abdomen. For most patients, the bloating improves over time as the remaining gas is absorbed by the body.
While mild swelling is common, it should gradually improve rather than continue to worsen. You should seek medical advice if you develop increasing redness, warmth, tenderness, pus, or fever around the wounds. These symptoms may indicate an infection that requires prompt assessment.
How the Incisions Heal
Healing of your incisions takes place in several stages after surgery. During the first few days, your body works to seal the wounds and begin repairing the skin and deeper tissues. This is a normal part of the recovery process and helps protect the surgical area.
Over the following weeks, the incisions gradually become stronger and less tender. You may notice that the skin appears healed quite quickly, but the tissues underneath continue to recover for much longer. This deeper healing is an important part of your overall recovery.
For this reason, your surgical team may advise you to avoid heavy lifting, strenuous exercise, and activities that place strain on your abdomen. Even when the wounds look healed on the surface, the deeper tissues still need time to regain strength. Following this advice can help support safe healing and reduce the risk of complications.
Can a Port-Site Hernia Develop?
A port-site or incisional hernia occurs when tissue pushes through a weakened area of the abdominal wall beneath a surgical wound. It can develop at any keyhole site, although larger port and specimen-retrieval sites may carry a greater risk.
You may notice a new lump or bulge that becomes more obvious when standing, coughing or straining. The area may also feel uncomfortable or tender.
Contact your surgical team or GP if you develop a new lump at an incision. Seek urgent same-day medical assessment if a new lump becomes painful, firm, discoloured, increasingly swollen or does not settle when you lie down. Attend A&E or call 999 if you also develop severe or rapidly worsening pain, repeated vomiting, collapse or marked abdominal swelling.
Avoiding heavy lifting until your team says it is safe may help protect the healing abdominal wall, although hernias can still occur even when recovery instructions are followed.
How Long the Incisions Take to Heal
The skin incisions often look substantially better within the first few weeks. However, the deeper layers of the abdominal wall continue healing after the surface appears closed, so activity restrictions may remain necessary. During this time, you may still experience some tenderness, firmness, numbness, or mild itching around the wound sites. These symptoms are usually part of the normal healing process.
Although the skin may appear to recover relatively quickly, the deeper tissues of your abdominal wall take longer to regain their strength. This is why your recovery plan focuses not only on how the incisions look but also on protecting the deeper layers as they continue to heal. Following activity restrictions can help prevent unnecessary strain on these tissues.
Your healing time will depend on several individual factors. These include your overall health, diabetes control, smoking status, body weight, nutrition, medications, and whether any complications occur after surgery. Your surgical team is best placed to advise you on when it is safe to increase your activity levels.
Showering and Cleaning the Incisions
NICE guidance advises that surgical wounds can generally be exposed to shower water after 48 hours. However, your hospital may give different instructions depending on your dressings, skin glue and how the wounds were closed.
When you shower, avoid scrubbing the incisions. Let clean water run gently over the area and pat it dry using a clean towel. Do not pull at glue, dressings, scabs or visible suture ends.
Your hospital may advise you to avoid baths, swimming and hot tubs until the wounds are fully closed and soaking has been confirmed as safe. Do not routinely apply antiseptic creams, powders, oils or antibiotic ointments unless they have been specifically prescribed.
UK Guidance Note
The BAUS robotic prostatectomy leaflet published in March 2024 states that the operation normally involves five or six keyhole abdominal incisions. It also explains that bruising and swelling can occur and lists pain, infection and hernia at a port site as recognised complications.
NICE guidance on surgical-site infection recommends giving you clear advice about caring for the wound, recognising possible infection and knowing whom to contact. It advises that showering is generally safe after 48 hours and that topical antimicrobial products should not routinely be applied to normally healing surgical wounds.
Your own discharge instructions remain important because the closure method, dressings and recovery protocol may differ between hospitals. Contact your clinical team when their advice differs from general guidance.
When to Worry About Infection
A small amount of redness, bruising, or mild tenderness around your incisions can be a normal part of healing. However, you should be aware of signs that may suggest an infection is developing. These can include spreading redness, increasing warmth, worsening swelling, pus, unpleasant discharge, fever, or increasing pain around the wound.
If you notice any of these symptoms, it is important not to ignore them. Wound infections can become more serious if they are not assessed and treated promptly. Paying attention to changes in your wounds can help you seek advice before the problem worsens.
You should contact your surgical team, GP, NHS 111, or an urgent care service, depending on the advice you have been given and the severity of your symptoms. If your wound is clearly getting worse, you should not wait several days to seek help. For you, early assessment is often the safest approach.
What About Bleeding From an Incision?
A small spot of blood on your dressing can be normal during the first few days after surgery. This may happen after you move around more, cough, or if the dressing rubs against your clothing. In many cases, the bleeding is minor and settles on its own.
However, you should seek advice if the bleeding continues, repeatedly soaks through the dressing, or is accompanied by swelling around the wound. This is particularly important if you take blood-thinning medication, as bleeding may be more difficult to control. Any significant change should be assessed by a healthcare professional.
You should never try to remove deep stitches or reopen a wound yourself. Follow the bleeding instructions in your discharge information. Contact your surgical team promptly if blood continues to soak through the dressing, the wound is actively bleeding or a new swelling is developing beneath it. Heavy bleeding, dizziness, fainting or rapidly increasing abdominal swelling requires urgent medical assessment.
Can an Incision Open After Surgery?
An incision can occasionally separate during healing. A small superficial gap is different from a deep wound opening, but both should be discussed with a healthcare professional.
- A small surface gap: The upper skin edges may separate slightly without exposing deeper tissue.
- Possible contributing factors: Infection, tension, repeated strain and delayed healing can increase the risk.
- Signs requiring prompt advice: Increasing redness, discharge, pain, swelling, persistent bleeding or enlargement of the opening should be reported.
- Do not close it yourself: Do not apply household adhesive, tape or non-prescribed products to the wound.
- Emergency warning: Seek emergency help if the wound opens widely, deeper tissue is visible or tissue protrudes through the opening.
Infection can interfere with healing and cause the wound edges to separate. Contact your surgical team promptly if a wound opens or develops increasing redness, warmth, swelling, pain, discharge or fever.
Will the Incisions Leave Scars?
All surgical incisions leave some degree of scarring, including those used during robotic prostate surgery. Because the incisions are small, the scars are usually small as well and are spread across different areas of the abdomen. For many men, they become less noticeable as healing progresses.
In the early stages, your scars may appear pink, red, or darker than the surrounding skin. Over the following months, they often fade and soften, although the final appearance varies from person to person. Factors such as your skin type, healing response, sun exposure, and whether the wound becomes irritated or infected can all influence how the scars develop.
You should protect healing scars from strong sunlight, as sun exposure can sometimes make them darker or more noticeable. Once your wounds have fully healed, your medical team may recommend simple scar-care measures if appropriate. Following your team’s advice may support normal scar healing and reduce avoidable irritation.
Why the Incision Number May Vary
The number of incisions used during your robotic prostate surgery may vary because every operation is slightly different. Lymph-node dissection is usually carried out through the existing robotic ports. However, an additional assistant port or a modified arrangement may occasionally be required according to the surgical platform, anatomy and operative needs.
Your previous surgical history can also affect port placement. If you have had abdominal surgery in the past, scar tissue may change the safest route for inserting the ports and positioning the instruments. Your surgeon will plan the operation carefully based on your individual anatomy and medical history.
Factors such as your body shape, prostate size, and the complexity of the procedure may also influence the final incision pattern. For you, the most important point is that the goal is not simply to use the fewest possible incisions. The priority is to place the ports in positions that provide safe and appropriate access for your surgical team.
What If You Have Previous Scars?
If you have scars from previous abdominal surgery, your surgeon will take them into account when planning your operation. Old scars can sometimes be associated with adhesions, which are internal bands of scar tissue that may have formed after earlier procedures. These adhesions can affect the safest way to access the abdomen.
Because of this, your surgeon may adjust the planned port positions or choose a different entry point for the robotic instruments. In some cases, extra care is needed when entering the abdomen to reduce the risk of injury to nearby structures. Careful planning helps ensure the operation can be performed as safely as possible.
You should make sure your surgeon knows about any previous abdominal, pelvic, bowel, bladder, hernia, or prostate procedures you have had. Even operations that seem minor can influence surgical planning. Providing a complete surgical history helps your team decide the safest approach for your individual case.
Are Single-Port Techniques Different?
Single-port robotic prostatectomy uses a specialised system that places the camera and several instruments through one main access incision. Depending on the surgical route and the surgeon’s technique, an additional assistant or drain site may still be used.
Single-port surgery is not available in every centre and is not automatically better for every patient. A 2025 systematic review included 21 studies and 1,400 patients, with eight comparative studies included in its meta-analysis. It reported broadly similar perioperative, functional and oncological results between single-port and multi-port approaches, although the evidence was limited by retrospective studies, short follow-up and relatively small specialist-centre cohorts.
A later 2025 updated meta-analysis reported lower early pain scores, reduced opioid use and some hospital-stay advantages with single-port surgery. It found no statistically significant differences in continence, potency, perioperative complications, positive surgical margins or biochemical recurrence. Because surgical approaches and study designs varied, the findings still require cautious interpretation.
The most appropriate system is the one that allows your operation to be carried out safely by an experienced team. The number of scars should not be considered more important than cancer treatment, surgical access and overall outcomes.
How Incisions Affect Movement
Your incisions may feel tight or sore when you stand up, twist, cough, laugh, or get out of bed. This happens because the skin and abdominal muscles around the wounds move whenever your body changes position. These sensations are common during the early stages of recovery.
You will usually be encouraged to start walking soon after surgery, as gentle movement helps improve circulation, breathing, bowel function, and overall recovery. However, you should avoid heavy lifting, strenuous exercise, and activities that place excessive strain on your abdomen until your team advises it is safe.
Try to move steadily and give your body time to adjust as you recover. If a particular movement causes sharp pain around your wounds, stop and seek advice from your healthcare team. Following their guidance can help protect your healing incisions and support a smoother recovery.
Clothing and Comfort After Surgery
After robotic prostate surgery, you may find that loose-fitting clothing is more comfortable during the early stages of recovery. Tight waistbands can place pressure on your incisions, dressings, and catheter tubing, which may increase discomfort. Choosing comfortable clothing can help you move around more easily.
Many patients prefer soft tracksuit bottoms, loose underwear, or clothing with adjustable waistbands for the first few days after surgery. If you are going home with a catheter, you may also find it helpful to wear clothing that provides enough space for the drainage bag and tubing. Small adjustments like these can make daily activities more manageable.
Your comfort is an important part of recovery. Clothing that rubs directly against a tender incision may cause irritation and make the area feel more sore. Choosing soft, non-restrictive garments can help protect the wounds while they continue to heal.
How Catheter Care Relates to Incisions
The urinary catheter used after robotic prostate surgery does not pass through your abdominal incisions. Instead, it passes through the urethra into the bladder and allows urine to drain while the bladder and urethra heal. The catheter and the incision sites are therefore separate parts of your recovery.
Even though the catheter is not connected to the abdominal wounds, the tubing can sometimes pull, twist, or catch on clothing. This may make movement feel uncomfortable and can increase awareness of the surgical area. Securing the catheter properly can help reduce strain and make it easier for you to move around confidently.
The timing of catheter removal varies between hospitals and individual patients. In many cases, the catheter is removed within one to two weeks after surgery, provided healing is progressing as expected. Your healthcare team will explain when removal is planned for you and what to expect during the process.
Myth vs Fact
| Myth | Fact |
| Every robotic prostatectomy uses exactly five incisions. | Five or six is common for standard multi-port surgery, but the number varies by platform and technique. |
| The specimen-retrieval wound is always an additional incision. | An existing port site is usually enlarged slightly to remove the prostate. |
| Lymph-node removal always requires another incision. | Pelvic lymph-node dissection is usually performed through the existing robotic ports. |
| Single-port surgery always leaves only one mark. | It uses one main access site, but an assistant or drain site may sometimes still be needed. |
| Small wounds mean robotic prostatectomy is minor surgery. | Radical prostatectomy remains a major pelvic operation with important risks and recovery needs. |
| A red wound always means infection. | Mild early redness can occur, but spreading redness, heat, worsening pain, discharge or fever requires advice. |
| Getting the incision wet will automatically make it open. | Showering is generally considered safe after 48 hours, although your hospital’s instructions should take priority. |
| Once the skin closes, the wound is fully healed. | The deeper abdominal tissues continue healing after the surface appears closed. |
| Robotic scars always disappear completely. | Scars usually fade, but every surgical incision leaves some permanent change to the skin. |
| A port-site lump is always normal swelling. | A new or persistent bulge may be an incisional hernia and should be assessed. |
Key Takeaways
- Standard multi-port robotic prostate surgery commonly uses five or six small abdominal incisions.
- The number and position can vary according to the robotic platform, surgical route and your anatomy.
- The camera, robotic instruments and assistant equipment use different access ports.
- The prostate is normally removed by enlarging one existing port incision slightly.
- Pelvic lymph-node removal does not routinely require a separate additional incision.
- Single-port surgery uses one main access site, but another assistant or drain site may sometimes be required.
- Bruising, tenderness and mild swelling can occur around the wounds during early recovery.
- The skin may look healed before the deeper abdominal wall has regained its strength.
- Follow your hospital’s instructions about dressings, showering, lifting and wound products.
- Spreading redness, heat, pus, fever, worsening pain, persistent bleeding or wound opening requires prompt advice.
- A new lump at an incision could represent a port-site hernia and should be assessed.
- The number of incisions alone does not determine surgical safety, cancer control or functional recovery.
FAQs:
1. How many incisions are usually made during robotic prostate surgery?
Standard multi-port robotic prostatectomy commonly uses five or six small abdominal incisions. These provide access for the camera, robotic instruments and bedside assistant. The exact number can vary, and single-port systems use a different arrangement. BAUS currently describes five or six incisions as the normal multi-port pattern.
2. How large are the incisions used in robotic prostate surgery?
On many multi-port systems, robotic instrument ports are approximately 8 mm and an assistant port may be around 12 mm. Exact incision and port sizes vary according to the robotic platform and surgical technique.
3. Where are the incisions located?
The incisions are generally arranged across the central and lower abdomen. Some may be close to or above the belly button, while others are positioned on the left and right sides. The exact pattern depends on the robotic system and surgical route.
4. How long do robotic prostate surgery incisions take to heal?
The skin wounds usually begin settling over the first few weeks, but the deeper tissues continue healing for longer. Tenderness, firmness, numbness or itching can remain after the surface looks closed. Follow your surgeon’s advice about lifting and exercise.
5. Are the incisions painful after surgery?
Some soreness and tenderness around the incision sites is normal after robotic prostate surgery. Discomfort is often most noticeable when standing up, coughing, or moving suddenly. Pain generally improves gradually and can usually be managed with the pain relief recommended by the surgical team. The specimen-retrieval incision may feel more uncomfortable because it is usually slightly larger than the other sites.
6. Will the incisions leave permanent scars?
All surgical incisions leave some degree of scarring, but robotic prostate surgery scars are usually small. The scars often appear red or pink initially and then fade over time. Their final appearance depends on factors such as skin type, healing response, and wound care during recovery.
7. Can the incision sites become infected?
A wound infection can occur after any surgical procedure. Contact your surgical team, GP or NHS 111 promptly if the wound develops increasing redness, warmth, swelling, discharge, worsening pain, opens or is accompanied by fever.
8. Can previous abdominal surgery affect the number or position of incisions?
Previous abdominal operations can influence where the surgeon places the ports. Internal scar tissue or adhesions may require adjustments to the usual port layout. The surgical team will review previous surgical history carefully when planning the procedure. Previous surgery does not automatically prevent robotic prostatectomy, but adhesions can alter the safest entry point or port arrangement.
9. Is robotic prostate surgery less invasive than open prostate surgery?
Robotic prostatectomy uses several small access wounds rather than the longer incision generally used for open surgery. This changes the external wound pattern and may support some early recovery advantages, but it remains a major operation and is not risk-free.
10. When should medical advice be sought about an incision after surgery?
Contact your surgical team, GP or NHS 111 promptly if an incision becomes increasingly red, hot, swollen or painful, produces discharge, opens or continues bleeding. Seek emergency help for heavy bleeding, fainting, severe abdominal pain, a widely opened wound or tissue protruding through it.
Final Thoughts: Understanding Your Robotic Prostate Surgery Incisions
Standard multi-port robotic prostatectomy commonly involves five or six small abdominal incisions. These provide access for the camera, robotic instruments and assistant equipment, while one existing port site is usually enlarged slightly to remove the prostate specimen.
The exact number and position depend on the robotic system, surgical route, your anatomy and any previous abdominal surgery. Single-port techniques use one main access site, but they are not suitable or available for every patient and may still require additional assistant access.
Although the external wounds are small, radical prostatectomy remains major surgery. Follow your own hospital’s advice about dressings, showering, lifting and activity, and seek prompt medical advice if a wound becomes increasingly painful, hot, swollen, red, begins discharging, opens or continues bleeding.
If you are considering treatment at a robotic prostate surgery clinic in London, your consultation should explain the planned port arrangement, which site is likely to be enlarged for specimen removal and how your wounds should be cared for after discharge.
References:
- British Association of Urological Surgeons (BAUS) (2024) Robotic-assisted radical prostatectomy (RARP). Available at: https://www.baus.org.uk/patients/information_leaflets/180/roboticassisted_radical_prostatectomy_rarp
- National Institute for Health and Care Excellence (NICE) (2019, last updated 2020) Surgical site infections: prevention and treatment. NICE guideline NG125. Available at: https://www.nice.org.uk/guidance/ng125
- National Institute for Health and Care Excellence (NICE) (2019, last updated 2021; reviewed 2025) Prostate cancer: diagnosis and management. NICE guideline NG131. Available at: https://www.nice.org.uk/guidance/ng131
- European Association of Urology (EAU) (2026) EAU guidelines on prostate cancer: treatment. Available at: https://uroweb.org/guidelines/prostate-cancer/chapter/treatment
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