Robotically assisted laparoscopic prostatectomy: an assessment of its contemporary role in the surgical management of localized prostate cancer

Abstract

Radical prostatectomy has maintained a cardinal role in the treatment of localized carcinoma of the prostate. The combination of refinements in surgical technique and better definition of the anatomy have decreased the morbidity from surgery. Nonetheless, concerns about treatment-related side effects remain the primary limitation of surgical therapy for prostate cancer. Laparoscopic prostatectomy, with or without robotic assistance, is playing an increasing role in surgical treatment of prostate cancer. However, the minimally invasive aspect of laparoscopy may have less relevance for radical prostatectomy because the open surgical procedure requires a limited infraumbilical incision. In the present series comparing robotically assisted laparoscopic prostatectomy with open radical retropubic prostatectomy, no difference was seen in postoperative pain, length of stay, or requirement for blood replacement. However, the most important outcome measures are tumor control, continence, and sexual potency. The outstanding visibility and precision afforded by the robotic approach may offer advantages in each of these areas.