Robot-assisted versus pure laparoscopic radical prostatectomy.
The aim of this study is to report the relative advantages and disadvantages of the radical prostatectomy with a laparoscopic (LRP) and a robotic (RALP) approach. A medline search was performed. Published data regarding perioperative parameters, complications, oncological results, functional results were analyzed. Shorter learning curves have been reported with the RALP. Intra-operative and post-operative outcomes appear to be comparable between the two approaches. The average time for LRP is 234 min (151-453) versus 182 min (141-250) for RALP. Estimated blood loss for the LRP averages 482 ml (185-850) versus 234 ml (75-500) for the RALP. Complication rates in single institution studies are similar. Long-term outcomes data on PSA progression is not yet available for LRP or RALP due to their relatively short existence. RALP appears to offer a significant benefit to the laparoscopically naïve surgeon with respect to learning curve when compared to LRP. This, however, comes at an increased cost. Intra-operative and post-operative outcomes appear to be similar. Longer follow-up data is necessary to compare oncological and functional outcomes.
Rozet
Francois
F
Department of Urology, Institut Montsouris, 42 bd Jourdan, 75014, Paris, France. francois.rozet@imm.fr
Harmon
Justin
J
Cathelineau
Xavier
X
Barret
Eric
E
Vallancien
Guy
G
D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D008297:Male; D011468:Prostatectomy / Q000009:adverse effects / Q000379:methods*; D012371:Robotics