Critical comparison of laparoscopic, robotic, and open radical prostatectomy: Techniques, outcomes, and cost

Abstract

Radical prostatectomy has maintained paramount importance in prostate cancer management. Emerging alternative treatments are laparoscopic and robotic prostatectomy. Technical modifications have improved radical prostatectomy outcomes, yet surgery remains difficult to perform regardless of approach. Contemporary series have shown comparable outcomes with operative time, transfusion rates, analgesia, and length of catheterization. Open radical prostatectomy provides excellent long-term oncologic control, but sparse shortterm data are available for laparoscopic and robotic prostatectomy. Favorable outcomes also have been reported for urinary control and sexual function, regardless of approach. Additional prospective data collection is needed to evaluate if minimally invasive approaches provide distinct advantages over open surgery.

Robot-assisted laparoscopic transvesical diverticulectomy and simple prostatectomy

“…Most remarkable is the expansion of the use of RALP. The learning curve is surmountable by many urologists, leading to the widespread use of this minimally invasive procedure [8,10]. With many urologists routinely performing RALP, the surgical skills required to perform other complex urologic surgeries in the pelvis represent untapped potential.…”

Radical prostatectomy for prostatic adenocarcinoma: a matched comparison of open retropubic and robot‐assisted techniques

“…Thus, if the baseline rate of complications was ≤ 1% then the study might not have enough patients to detect small differences between the treatments. Third, the QoL questionnaire completed by patients has not been validated and was devised by our department [14]. Nonetheless, the criteria used for both study cohorts were equivalent and differences in QoL outcomes were comparable.…”

“…Given the novelty and interest in minimally invasive/ minimal access options, studies comparing the laparoscopic approaches to RRP have been published [5,7,[12][13][14]. Collectively, these reports have improved our understanding of perioperative morbidity and quality-of-life (QoL) differences among treatment approaches.…”

Prostatectomía radical endoscópica extraperitoneal: ¿cuál es la pendiente de la curva de aprendizaje? Efectos en la técnica de evolución personal en una experiencia de 5 años

“…La prostatectomía radical es una té cnica en continua evolució n. En cualquiera de sus tres modalidades (abierta, laparoscó pica o robó tica), está totalmente consolidada como tratamiento del cá ncer de pró stata localizado con una esperanza de vida superior a los 10 añ os 18 . Despué s de analizar las experiencias publicadas má s importantes, es muy difícil establecer una comparació n objetiva, ya que no existen series suficientemente significativas que hayan comparado las tres té cnicas de forma prospectiva y aleatorizada.…”