Assaad El-Hakim1, Robert A Leung, Ashutosh Tewari. 1. Program in Robotic Prostatectomy and Urologic Oncology Outcomes, Weill Medical College of Cornell University, New York, NY 10021, USA. ashtewari@med.cornell.edu
Abstract
OBJECTIVE: Robotic prostatectomy has been recently added to the treatment armamentarium of localized prostate cancer. We reviewed published data on this modality with critical appraisal of outcomes and complications. METHODS: A Medline search was performed that encompassed all published articles on robotic prostatectomy. Select data on open radical retropubic (RRP) and laparoscopic (LP) prostatectomy from centers of excellence in the USA and Europe were included for objective comparison. Perioperative parameters, pathological results, including surgical margin rate, complications and postoperative continence and potency rates were reported. Advantages and shortcomings of robotic prostatectomy, and the learning curve and cost issues were also addressed. RESULTS: Robotic prostatectomy offers advantages of minimally invasive access surgery, including enhanced visualization, decreased bleeding and transfusion rate, shorter hospital stay and faster recovery. Pathological outcomes are comparable to RRP and LP with acceptable positive margin rate. At short-term follow-up, continence and potency results appear to be equivalent to RRP and LP. The learning curve of robotic prostatectomy is faster than that of LP. Cost remains a matter of debate at the present time. Long-term cancer control results of robotic prostatectomy are still maturing. CONCLUSIONS: Robotic prostatectomy is a promising minimally invasive surgical approach for men with localized prostate cancer. Short-term clinical and pathological results compare favorably to RRP and LP.
OBJECTIVE: Robotic prostatectomy has been recently added to the treatment armamentarium of localized prostate cancer. We reviewed published data on this modality with critical appraisal of outcomes and complications. METHODS: A Medline search was performed that encompassed all published articles on robotic prostatectomy. Select data on open radical retropubic (RRP) and laparoscopic (LP) prostatectomy from centers of excellence in the USA and Europe were included for objective comparison. Perioperative parameters, pathological results, including surgical margin rate, complications and postoperative continence and potency rates were reported. Advantages and shortcomings of robotic prostatectomy, and the learning curve and cost issues were also addressed. RESULTS: Robotic prostatectomy offers advantages of minimally invasive access surgery, including enhanced visualization, decreased bleeding and transfusion rate, shorter hospital stay and faster recovery. Pathological outcomes are comparable to RRP and LP with acceptable positive margin rate. At short-term follow-up, continence and potency results appear to be equivalent to RRP and LP. The learning curve of robotic prostatectomy is faster than that of LP. Cost remains a matter of debate at the present time. Long-term cancer control results of robotic prostatectomy are still maturing. CONCLUSIONS: Robotic prostatectomy is a promising minimally invasive surgical approach for men with localized prostate cancer. Short-term clinical and pathological results compare favorably to RRP and LP.
Authors: Shiva Jayaraman; Douglas Quan; Ibrahim Al-Ghamdi; Firas El-Deen; Christopher M Schlachta Journal: Surg Endosc Date: 2009-07-25 Impact factor: 4.584
Authors: Dimitrios Stefanidis; Fikre Wang; James R Korndorffer; J Bruce Dunne; Daniel J Scott Journal: Surg Endosc Date: 2009-06-18 Impact factor: 4.584
Authors: Kevin C Zorn; Frederick P Mendiola; David E Rapp; Albert A Mikhail; Shang Lin; Marcelo A Orvieto; Gregory P Zagaja; Arieh L Shalhav Journal: J Robot Surg Date: 2007-01-24