The “halo effect” in Korea: change in practice patterns since the introduction of robot-assisted laparoscopic radical prostatectomy

Abstract

Acquisition of the da Vinci surgical system (Intuitive Surgical, Mountain View, USA) has enabled robot-assisted surgery to become an acceptable alternative to open radical prostatectomy (ORP). Implementation of robotics at a single institution in Korea induced a gradual increase in the number of performances of robot-assisted laparoscopic radical prostatectomy (RALP) to surgically treat localized prostate cancer. We analyzed the impact of robotic instrumentation on practice patterns among urologists and explain the change in value in ORP and RALP-the standard treatment and the new approach or innovation of robotic technology. The overall number of prostatectomies has increased over time because the number of RALPs has grown drastically whereas the number of OPRs did not decrease during the period of evaluation. Our experience emphasizes the potential of RALP to become the gold standard in the treatment of localized prostate cancer in various parts of the world.

Trends in treatment for localized prostate cancer after emergence of robotic-assisted laparoscopic radical prostatectomy in Taiwan

“…This gradual country-to-country increase is called the "halo effect". 8 We found the same phenomenon to be true at TCVGH; cases have increased from year to year since the introduction of RALP. Of the 243 patients in this study, 141 (58.02%) were diagnosed at other hospitals and transferred to our hospital specifically for RALP.…”

The Change of Prostate Cancer Treatment in Korea: 5 Year Analysis of a Single Institution

“…However, the proportion had increased to more than 65% in 2008 through 2009 6. The same phenomenon was also reported in Korea, where RALP was increased dramatically from 8% to 77% between 2005 and 2008 7. In Korea, robot-assisted laparoscopic radical prostatectomy using the DaVinci® robotic system (intuitive surgical Inc., Sunnyvale, CA, USA) was introduced in 2005.…”

“…However, our findings indicate that the main treatment after diagnosis of prostate cancer is radical prostatectomy including RRP and RALP. This finding is not true for only our institute 7. The advantages of robotic surgery are introduced to patients intensively by the mass media, and radical surgery for prostate cancer is simultaneously advertised as a definite curative option.…”

Robot-Assisted Radical Prostatectomy in Hong Kong: A Review of 235 Cases

“…Since the implementation of robotics in the Asian region, a dramatic increase in the number of RALP has been seen. 7 This ''halo effect,'' as referred to by Sung and colleagues, 8 contributes to the evolution of robotic surgical techniques into maturity in the region. Hong Kong had its first robotic system installed in 2005 9 and is among the first few cities in Asia that acquired such technology.…”