Re: Comparison of radical prostatectomy techniques: open, laparoscopic and robotic assisted

Abstract

This timely paper reviews the current status and respective roles of laparoscopic, robotically-assisted and open radical prostatectomy in the management of localized prostate cancer. While open radical prostatectomy remains the gold standard of treatment, a minimally-invasive approach has been available since 1997 in the form of laparoscopic radical prostatectomy. Minimally-invasive approaches to radical approach seen with other procedures, including decreased patient blood loss and post-operative recovery time. The increased visualization, through digitally enhanced images that both magnify and illuminate the of this technically challenging procedure. However, laparoscopic surgery requires the acquisition of new anatomical perspectives, hand-eye coordination and the capacity to operate with limited tactile feedback and lack of 3-dimensional vision, all of which contributes to its undeniably steep learning curve. More recently, robotic systems have been used as an additional tool for the laparoscopic approach, with the hypothesis that they might improve the precision and accuracy of the anatomical dissection for the reasons outlined in the introduction of the current paper.The authors concisely summarize the available contemporary literature, paying most attention to larger series from centers with established reputations for comparison include operative, oncological and functional outcomes, as well as a pertinent discusminimally-invasive approaches are seen in generally lower operative blood loss, marginally decreased complication rates and shorter duration of catheterization. length of hospital stay often depends on more than simply the operative technique involved. Data concerning functional outcomes appears to be similar across the different techniques, but the authors rightly point out -and the use of validated questionnaires. The long as yet limited long-term follow up is available for the survival appears comparable in the short to medium term, and what comparative studies exist show no Our own unit recently published a direct comparison of robotic-assisted versus pure laparoscopic were observed between the pure laparoscopic and the robotic-assisted procedure with regard to operative time, operative blood loss, length of hospital stay or seen in the robotic-assisted group (9.8%) compared to not been borne out in other similar studies (2,3). No