Robot‐assisted vs pure laparoscopic radical prostatectomy: are there any differences?

Joseph, Jean; Vicente, Ivelisse; Madeb, Ralph; Ertürk, Erdal; Patel, Hitendra

doi:10.1111/j.1464-410x.2005.05563.x

Cited by 137 publications

(97 citation statements)

References 17 publications

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“…Initial outcomes of earlier RALP series have shown the feasibility of the procedure [8,9,11,13]. Some studies comparing pure LRP and RALP have also been published and showed interesting results after RALP [5,16,17]. Moreover, the use of a robotic system reduces the difficulty of complex laparoscopic techniques and seems to decrease markedly the learning curve compared with pure LRP.…”

Section: Discussionmentioning

confidence: 96%

Robot‐assisted extraperitoneal laparoscopic radical prostatectomy: experience in a high‐volume laparoscopy reference centre

et al. 2010

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surgeon were distributed into five groups according to the chronological order of the procedures. The mean follow-up after RALP was 18.3 months. Patient demographics, surgical data and postoperative variables were collected into a prospective database. Data were compared by chronological groups into single-surgeon cohort. RESULTSThe median operative time and blood loss were 140 min and 350 mL, respectively. The complication rate was 8.3%. Cancers were pT3-4 in 34.5%. The mean hospital stay and duration of bladder catheterization were 4.3 and 8.2 days, respectively. The rate of positive surgical margins (PSMs) was 17.2% in pT2 cancers. The recovery rate of continence was 98% at 12 months. Intraoperative time, blood loss and length of hospital stay were significantly improved after a short learning curve. The continence recovery, the rate and the length of PSM were also improved beyond the learning curve, but difference was not statistically significant. CONCLUSIONSRALP is a safe and reproducible procedure and offers a short learning curve for experienced laparoscopic surgeons. Beyond the learning curve, continued experience might also provide further improvements in terms of operative, pathological and functional results. KEYWORDSprostate cancer, radical prostatectomy, robotic assistance, learning curve Study Type -Therapy (case series) Level of Evidence 4 OBJECTIVETo describe our current procedure of robotassisted laparoscopic radical prostatectomy (RALP), and to assess the effect of the learning curve on perioperative data, early oncological outcomes and functional results, as RALP has increasingly become a treatment option for men with localized prostate cancer.

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Section: Discussionmentioning

confidence: 96%

Robot‐assisted extraperitoneal laparoscopic radical prostatectomy: experience in a high‐volume laparoscopy reference centre

et al. 2010

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“…Regarding the comparison between RARP and LRP, Joseph and associates 74 conducted a single retrospective study that compared noncontemporary series of patients who were evaluated for erectile function recovery after LRP and RARP. At 3 months after surgery, only a nonstatistically significant trend in favor of RARP was observed.…”

Section: Potency Outcomesmentioning

confidence: 99%

Retropubic, Laparoscopic, and Robot-Assisted Radical Prostatectomy: A Critical Review of Outcomes Reported by High-Volume Centers

Coelho

Rocco

Patel

et al. 2010

Journal of Endourology

245

149

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Purpose: To critically review perioperative outcomes, positive surgical margin (PSM) rates, and functional outcomes of several large series of retropubic radical prostatectomy (RRP), laparoscopic RP (LRP), and robotassisted radical prostatectomy (RARP) currently available in the literature. Methods: A Medline database search was performed from November 1994 to May 2009, using medical subject heading search terms ''prostatectomy'' and ''Outcome Assessment (Health Care)'' and text words ''retropubic,'' ''robotic,'' and ''laparoscopic.'' Only studies with a sample size of 250 or more patients were considered. Weighted means were calculated for all outcomes using the number of patients included in each study as the weighing factor. Results: We identified 30 articles for RRP, 14 for LRP, and 14 for RARP. The mean intraoperative and postoperative RRP transfusion rates for RRP, LRP, and RARP were 20.1%, 3.5%, and 1.4%, respectively. The weighted mean postoperative complication rates for RRP, LRP, and RARP were 10.3% (4.8% to 26.9%), 10.98% (8.9 to 27.7%), and 10.3% (4.3% to 15.7%), respectively. RARP revealed a mean overall PSM rate of 13.6%, whereas LRP and RRP yielded a PSM of 21.3% and 24%, respectively. The weighted mean continence rates at 12 month follow-up for RRP, LRP, and RARP were 79%, 84.8%, and 92%, respectively. The weighted mean potency rates for patients who underwent unilateral or bilateral nerve sparing, at 12 month follow-up, were 43.1% and 60.6% for RRP, 31.1% and 54% for LRP, and 59.9% and 93.5% for RARP. Conclusion: RRP, LRP, and RARP performed in high-volume centers are safe options for treatment of patients with localized prostate cancer, presenting similar overall complication rates. LRP and RARP, however, are associated with decreased operative blood loss and decreased risk of transfusion when compared with RRP. Our analysis including high-volume centers also showed lower weighted mean PSM rates and higher continence and potency rates after RARP compared with RRP and LRP. However, the lack of randomized trials precludes definitive conclusions.

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“…After the introduction of serum prostate specific antigen (PSA) into the clinical screening strategy for prostate cancer, the stage at pathologic confirmation has decreased. As a result, most of the diseases discovered have been localized cancers (1). For these localized tumors, radical prostatectomy (RP) is the standard established treatment option, and the goals of RP in this stage are cancer cure, minimization of complications and perioperative suffering, and preservation of urinary continence and erectile function (2).…”

Section: Introductionmentioning

confidence: 99%

Biopsy Related Prostate Status Does Not Affect on the Clinicopathological Outcome of Robotic Assisted Laparoscopic Radical Prostatectomy

Choi

Kang

et al. 2009

Cancer Res Treat

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Robot‐assisted vs pure laparoscopic radical prostatectomy: are there any differences?

Cited by 137 publications

References 17 publications

Robot‐assisted extraperitoneal laparoscopic radical prostatectomy: experience in a high‐volume laparoscopy reference centre

Robot‐assisted extraperitoneal laparoscopic radical prostatectomy: experience in a high‐volume laparoscopy reference centre

Retropubic, Laparoscopic, and Robot-Assisted Radical Prostatectomy: A Critical Review of Outcomes Reported by High-Volume Centers

Biopsy Related Prostate Status Does Not Affect on the Clinicopathological Outcome of Robotic Assisted Laparoscopic Radical Prostatectomy

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