Background Laparoendoscopic single-site surgery radical prostatectomy (LESS-RP) is a challenging urological procedure and needs to be further evaluated.This study was undertaken to illustrate the safety and initial results of pure LESS-RP with conventional available instruments.Methods A prospective clinical database was established in September 2010 to assess the outcome following the introduction of LESS-RP at our institution.By June 2012,six procedures had been performed.The mean patient age was 74.7 (74.0-76.0) years.The mean body mass index (BMI) was 23.8 (19.5-32.2) kg/m2.The LESS-RP was preformed through an extra-peritoneal approach using single port access with QudaPort,0° lens 5 mm flexible tip video-laparoscope and available conventional laparoscopic instruments.Parameters assessed were operative time,estimated blood loss,intra-operative complications,drainage time,postoperative pain score (visual analogue pain scale (VAPS),0-10),pathological results,and postoperative prostate specific antigen (PSA) levels.Results LESS-RP was completed for all six cases without additional trocar placement or conversion to standard laparoscopic or open radical prostatectomy.The mean operative times were 252.5 (190.0-305.0) minutes,estimated blood loss was 300 (100-500 ml).There was no documentable intraoperative complication.The mean wound-drainage time was 5.2 (2.0-7.0) days,and the first postoperative day VAPS was 0.8 (0-3.0).Final pathological staging was pT2aN0M0 in four cases and pT2cN0M0 in two cases.Surgical margins were negative for all cases.The one-month post-operative PSA was less than 0.02 ng/ml in each case.All patients were continent without pad usage at 1 year postoperatively.Conclusion The technique of pure LESS-RP is feasible and early outcomes are acceptable.