Current status of robot-assisted laparoscopic radical prostatectomy: how does it compare with other surgical approaches?

The aim was to review the current status and evaluate the outcomes of robot-assisted laparoscopic radical prostatectomy in comparison with open radical prostatectomy and laparoscopic radical prostatectomy. Between January 2008 and June 2012, published English language comparative studies comparing robot-assisted laparoscopic radical prostatectomy with either open radical prostatectomy and/or laparoscopic radical prostatectomy were reviewed. End-points for this review include oncological, functional and perioperative outcomes, and complications. Compared with laparoscopic radical prostatectomy and/or open radical prostatectomy, robot-assisted laparoscopic radical prostatectomy offered at least equivalent oncological control. Current evidence seems to suggest a superiority of robot-assisted laparoscopic radical prostatectomy over open radical prostatectomy and laparoscopic radical prostatectomy in terms of functional outcomes, such as urinary continence and potency. Risks of perioperative complications were also low after robot-assisted laparoscopic radical prostatectomy. Robot-assisted laparoscopic radical prostatectomy offers at least equivalent oncological and functional outcomes with low risks of complications when compared with open radical prostatectomy and laparoscopic radical prostatectomy. However, there is a paucity of high-level evidence available in current literature.