title: Robot-Assisted Simple Prostatectomy: Expanding on an Established Operative Approach.
abstract: OBJECTIVE
  The leading cause of voiding dysfunction in older men is benign prostatic obstruction. In the setting of a grossly enlarged prostate (>80cm3), an open simple prostatectomy has been the gold standard for surgical treatment. Here, we will discuss the minimally invasive robot-assisted approach and compare it to the classic open approach and holmium laser enucleation of the prostate.
  
  
  RESULTS
  Literature on robot-assisted simple prostatectomy, in concurrence with our institutional experience, has shown an overall lower morbidity, shorter hospital stay, and decreased indwelling catheter time, with equivalent functional outcomes compared to open simple prostatectomy. Similar operative times and hospital stays were found compared to holmium laser enucleation of the prostate, although a steep learning curve and cost of new equipment hinder the wide spread use of this transurethral approach. On review of current literature in addition to our institutional experience, we favor robot-assisted simple prostatectomy over open simple, based on associated increased morbidity/catheter time/hospital stay, and holium laser enucleation of the prostate, based on steep learning curve and cost of new equipment.
authors.affiliation: University of Pennsylvania, 51 N 39th St., MOB 300, Philadelphia, PA, 19104, USA.
authors.forename: Ross
authors.initials: R
authors.lastname: Cockrell
authors.affiliation: University of Pennsylvania, 51 N 39th St., MOB 300, Philadelphia, PA, 19104, USA. david.lee@uphs.upenn.edu.
authors.forename: David I
authors.initials: DI
authors.lastname: Lee
mesh_terms: D006801:Humans; D053685:Laser Therapy; D053844:Lasers, Solid-State / Q000627:therapeutic use; D008297:Male; D011468:Prostatectomy / Q000295:instrumentation* / Q000379:methods*; D011470:Prostatic Hyperplasia / Q000150:complications / Q000601:surgery*; D065287:Robotic Surgical Procedures
keywords: Benign prostatic obstruction; Holmium laser enucleation of the prostate (HoLEP); Open simple prostatectomy; Robotic simple prostatectomy