Outcomes of robotic assisted radical prostatectomy.
Robot-assisted radical prostatectomy (RARP) is a rapidly evolving technique for the treatment of localized prostate cancer. However, cynics point to the increasing role of market forces in the robotic revolution. As yet, Europe has not taken up RARP in large numbers and this may in part relate to the high level of expertise in laparoscopy previously gained. Furthermore, setting up a robotic program is a major undertaking for many surgical units. This article reviews the current literature on RARP with regard to oncologic, continence and potency outcomes - the so called 'trifecta'. Preliminary data appears to show an advantage of RARP over open prostatectomy with reduced blood loss, decreased pain, early mobilization, shorter hospital stay and lower margin rates. Most intra-institutional studies demonstrate good postoperative continence and potency with RARP; however this needs to be viewed in the context of a paucity of randomized data available in the literature. There is no definitive data to show an advantage over standard laparoscopy, but the fact that this technique has reached parity with laparoscopy within 5 years is encouraging.
Dasgupta
Prokar
P
Guy's and St. Thomas' Hospitals, King's College London School of Medicine, London, UK. prokarurol@gmail.com
Kirby
Roger S
RS
D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical / Q000503:physiopathology; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation / Q000379:methods; D010147:Pain Measurement; D010149:Postoperative Pain / Q000503:physiopathology; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000453:epidemiology; D011379:Prognosis; D011468:Prostatectomy / Q000295:instrumentation* / Q000379:methods; D011471:Prostatic Neoplasms / Q000401:mortality / Q000601:surgery*; D018570:Risk Assessment; D012371:Robotics / Q000295:instrumentation / Q000379:methods*; D015996:Survival Rate; D016896:Treatment Outcome