Nation's First Fluorescence-Guided Da Vinci Posterior Approach Radical Prostatectomy Completed

Background

Prostate cancer is commonly diagnosed in men following elevated levels of prostate-specific antigen (PSA), with confirmation typically obtained through biopsy. Radical prostatectomy serves as a standard curative approach for localized prostate cancer. Robotic-assisted laparoscopic radical prostatectomy using the Da Vinci system has been adopted in many centers for its enhanced precision, three-dimensional visualization and minimally invasive nature compared to traditional methods.

The Affiliated Hospital of Qingdao University has developed expertise in urologic oncology and robotic surgery. Professor Yang Xuecheng, deputy director of urology, ward director and head of the prostate cancer subspecialty, leads a team focused on minimally invasive treatments for prostate tumors. The team had previously completed Qingdao's first Da Vinci robot-assisted posterior approach radical prostatectomy.

What was achieved

In early June 2026, Professor Yang Xuecheng led his team to complete China's first fluorescence-guided Da Vinci surgical robot posterior approach radical prostatectomy. The patient had presented at the hospital's Shinan campus two weeks earlier with elevated PSA and was diagnosed with prostate cancer via routine outpatient prostate biopsy. Intraoperatively, the tumor was located in the right transition zone of the prostate and measured 1.8 by 2.0 centimeters.

Fluorescence imaging enabled precise tumor localization. The procedure achieved complete tumor excision while protecting the patient's sexual function and urinary continence, with the aim of improving prognosis. This marked the first national application of fluorescence guidance combined with the posterior surgical approach using the Da Vinci robot.

How it works

Radical prostatectomy entails surgical removal of the prostate gland and seminal vesicles to eliminate localized cancer. Traditional anterior approaches require division of the puboprostatic ligaments, endopelvic fascia and mobilization of the bladder from the anterior abdominal wall, disturbing structures in the Retzius space. The posterior approach instead accesses the prostate from behind, between the prostate and rectum, without entering the Retzius space.

This preserves the puboprostatic ligaments, anterior pelvic floor support tissues, dorsal venous complex and anterior prostatic fascia, maximizing retention of pelvic floor anatomical structures. Multiple randomized controlled trials have indicated that patients undergoing the posterior approach achieve substantially higher immediate continence rates in the days to one month after urinary catheter removal, reaching levels that traditional anterior approaches typically attain only at three to six months postoperatively.

The Da Vinci robot provides high-definition three-dimensional visualization and articulated instruments for precise dissection. Fluorescence guidance employs a tracer targeting prostate-specific membrane antigen (PSMA) expressed on cancer cells. When activated under near-infrared light integrated in the robotic system, it produces real-time, non-invasive, in-situ visualization of tumor tissue, microscopic lesions, potential positive margins and involved lymph nodes that may not be apparent under standard white-light vision. This helps reduce positive surgical margins and supports precise pelvic lymph node dissection.

What it means for international patients

The Affiliated Hospital of Qingdao University operates a dedicated Department of International Medical Treatment and International Outpatient services. These provide a platform with senior experts and subject leaders for high-quality, convenient appointments, medical treatment coordination and support tailored to foreign patients, overseas guests and VIPs. The service includes dedicated appointment hotlines and priority arrangements for consultations and diagnostics.

International patients interested in advanced robotic techniques for prostate cancer, such as fluorescence-guided or posterior-approach radical prostatectomy, should contact the hospital directly. Eligibility, suitability and current availability depend on individual diagnostic findings, staging and medical assessment. Patients are advised to confirm all details, including requirements for international care, with the hospital.

About the hospital

The Affiliated Hospital of Qingdao University is a large provincial tertiary Grade A comprehensive public hospital located in Qingdao, Shandong Province. It is directly affiliated with Qingdao University and maintains multiple campuses, including the Shinan campus. The institution has a history dating to 1898 and participates in national medical programs.

Its urology department features more than 200 beds, conducts over 12,000 surgeries annually and performs more than 1,000 ultrasound-guided prostate biopsies per year. The department routinely carries out Da Vinci robot-assisted radical prostatectomies and has introduced multiple innovative minimally invasive techniques. It maintains an International Medical Department offering services to foreign patients.