title: EAU guidelines on robotic and single-site surgery in urology.
abstract: BACKGROUND
  This is a short version of the European Association of Urology (EAU) guidelines on robotic and single-site surgery in urology, as created in 2013 by the EAU Guidelines Office Panel on Urological Technologies.
  
  
  OBJECTIVE
  To evaluate current evidence regarding robotic and single-site surgery in urology and to provide clinical recommendations.
  
  
  METHODS
  A comprehensive online systematic search of the literature according to Cochrane recommendations was performed in July 2012, identifying data from 1990 to 2012 regarding robotic and single-site surgery in urology.
  
  
  RESULTS
  There is a lack of high-quality data on both robotic and single-site surgery for most upper and lower urinary tract operations. Mature evidence including midterm follow-up data exists only for robot-assisted radical prostatectomy. In the absence of high-quality data, the guidelines panel's recommendations were based mostly on the review of low-level evidence and expert opinions.
  
  
  CONCLUSIONS
  Robot-assisted urologic surgery is an emerging and safe technology for most urologic operations. Further documentation including long-term oncologic and functional outcomes is deemed necessary before definite conclusions can be drawn regarding the superiority or not of robotic assistance compared with the conventional laparoscopic and open approaches. Laparoendoscopic single-site surgery is a novel laparoscopic technique providing a potentially superior cosmetic outcome over conventional laparoscopy. Nevertheless, further advantages offered by this technology are still under discussion and not yet proven. Due to the technically demanding character of the single-site approach, only experienced laparoscopic surgeons should attempt this technique in clinical settings.
  
  
  RESULTS
  This work represents the shortened version of the 2013 European Association of Urology guidelines on robotic and single-site surgery. The authors systematically evaluated published evidence in these fields and concluded that robotic assisted surgery is possible and safe for most urologic operations. Whilst laparoendoscopic single-site surgery is performed using the fewest incisions, the balance between risk and benefit is currently unclear. The evidence to support the conclusions in this guideline was generally poor, but best for robotic assisted radical prostatectomy. As such, these recommendations were based upon expert opinion, and further high-quality research is needed in this field.
authors.affiliation: Department of Urology and Urologic Oncology Medical School of Hanover (MHH), Hanover, Germany. Merseburger.Axel@mh-hannover.de
authors.forename: Axel S
authors.initials: AS
authors.lastname: Merseburger
authors.forename: Thomas R W
authors.initials: TR
authors.lastname: Herrmann
authors.forename: Shahrokh F
authors.initials: SF
authors.lastname: Shariat
authors.forename: Iason
authors.initials: I
authors.lastname: Kyriazis
authors.forename: Udo
authors.initials: U
authors.lastname: Nagele
authors.forename: Olivier
authors.initials: O
authors.lastname: Traxer
authors.forename: Evangelos N
authors.initials: EN
authors.lastname: Liatsikos
mesh_terms: D019317:Evidence-Based Medicine / Q000592:standards; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000592:standards*; D012371:Robotics / Q000592:standards*; D025321:Surgery, Computer-Assisted / Q000009:adverse effects / Q000592:standards*; D016896:Treatment Outcome; D013520:Urologic Surgical Procedures / Q000009:adverse effects / Q000592:standards*; D014572:Urology / Q000379:methods / Q000592:standards*
keywords: Conversions and complications; EAU; Guidelines; Incontinence; LESS (partial) nephrectomy; LESS adrenalectomy; LESS cystectomy; LESS prostatectomy; LESS pyeloplasty; LESS radical nephroureterectomy; Laparoscopic single-site surgery; Learning curve; Partial nephrectomy; Patient safety; Pelvic lymph node dissection; Potency; Radical cystectomy; Radical prostatectomy; Reconstructive renal surgery; Robot-assisted; Sacrocolpopexy; Urological surgery