Radikale Prostatektomie – pro robotisch

Abstract

Anatomical radical prostatectomy was introduced in the early 1980s by Walsh and Donker. Elucidation of key anatomical structures led to a significant reduction in the morbidity of this procedure. The strive to achieve similar oncological and functional results to this gold standard open procedure but with further reduction of morbidity through a minimally invasive access led to the establishment of laparoscopic prostatectomy. However, this procedure is complex and difficult and is associated with a long learning curve. The technical advantages of robotically assisted surgery coupled with the intuitive handling of the device led to increased precision and shortening of the learning curve. These main advantages, together with a massive internet presence and aggressive marketing, have resulted in a rapid dissemination of robotic radical prostatectomy and an increasing patient demand. However, superiority of robotic radical prostatectomy in comparison to the other surgical therapeutic options has not yet been proven on a scientific basis. Currently robotic-assisted surgery is an established technique and future technical improvements will certainly further define its role in urological surgery. In the end this technical innovation will have to be balanced against the very high purchase and running costs, which remain the main limitation of this technology.

First Report on Joint Use of a Da Vinci® Surgical System with Transfer of Surgical Know-How between Two Public Hospitals

“…To meet this challenge, we have searched for innovative solutions that would allow us to keep pace with modern advances in minimally invasive urological surgery, especially RARP. Moreover, robotic surgery is an important marketing item for recruitment of patients [23,24,25]. The learning curve for new technologies like RARP [26,27,28] can take years in small centers working entirely independently of one another.…”