Robotic‐assisted radical prostatectomy: a review of current outcomes

Abstract

With the widespread diffusion of the screening for prostate cancer, the disease has been diagnosed more commonly in the organ-confined stage, and in younger and healthier men. For these patients, radical prostatectomy (RP) is still the standard treatment. In an effort to decrease the morbidity associated with open RP, minimally invasive approaches have been described, including robotic-assisted RP (RALP). Almost one decade after the introduction of RALP, large and mature series have now been reported. We reviewed the outcomes of the largest series of RALP published recently. We searched Medline for reports published between 2006 and 2009, to identify articles describing intraoperative data, surgical complications, oncological outcomes, continence and potency rates after RALP. Relevant articles were selected and the outcomes evaluated.

Robot-Assisted Radical Prostatectomy

“…The magnification of 10 to 20 times, the excellent degrees of freedom for movement of the instruments and the intuitive handling of the machine are advantages compared with the open or standard laparoscopic approaches (7,27,33,36). Although evidence for better oncological and functional results are still unproven robotic assisted radical prostatectomy (1,3,15,21,26,39) is in many countries now the standard of care for the surgical removal of the prostate (4,6,22).…”

Perioperative, oncological, and functional outcomes of the first robotic prostatectomy program in Quebec: Single fellowship-trained surgeon's experience of 250 cases

“…Coelho and colleagues performed a meta-analysis on potency after RARP from pooled literature of centres of excellence. 15 Weighted mean potency rates were 61.1%, 71.2% and 94% at 6, 12 and >18 months, respectively. In a population-based study from a Quebecwide RRP cohort between 1988 and 1996, Karakiewicz and colleagues studied 2227 men without erectile dysfunction before surgery.…”

Gynecological Surgery and the Robot

“…Specific improvements associated with robot-assisted surgery include better visualization through the use of three-dimensional magnification, availability of tools with 7 degrees of freedom that mimic hand movements along with improved ergonomics and more intuitive hand-eye coordination when controlling surgical instruments [90][91][92]. However, this has been achieved at the cost of haptic and tactile feedback, as a result of the instruments being indirectly manipulated by the surgeon [93].…”