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. 2010 Winter;12(1):35-43.

Open Versus Laparoscopic Versus Robot-Assisted Laparoscopic Prostatectomy: The European and US Experience

Julia Finkelstein  1 , Elisabeth Eckersberger, Helen Sadri, Samir S Taneja, Herbert Lepor, Bob Djavan
Affiliations

Open Versus Laparoscopic Versus Robot-Assisted Laparoscopic Prostatectomy: The European and US Experience

Julia Finkelstein et al. Rev Urol. 2010 Winter.

Abstract

Open radical prostatectomy (ORP) is the reference standard for the surgical management of localized prostate cancer. With wider availability of minimally invasive radical prostatectomy techniques, there is a debate regarding the standard treatment of the management of localized prostate cancer. Therefore, we reviewed the current status of laparoscopic radical prostatectomy (LRP) and robotic-assisted laparoscopic radical prostatectomy (RALRP) as compared with ORP. Because no prospective, randomized trials comparing the different techniques have been performed, outcomes must be assessed from published series by centers that focus on ORP, LRP, and RALRP. Aside from reducing the amount of blood loss, current data suggest that the most significant outcomes (cure, continence, and potency) are no better with LRP or RALRP than with conventional ORP. Therefore, in experienced hands, ORP remains the gold standard procedure. However, there is a trend toward consistently better outcomes following RALRP in comparison with LRP. In the end, individual patient outcomes can be maximized by choosing the best modality based on the patient's comorbid medical conditions, cancer characteristics, and surgeon experience. Future studies are needed to further investigate long-term cancer control as well as functional outcomes for RALRP series.

Keywords: Laparoscopy; Prostatectomy; Prostatic neoplasms; Robotics.

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Figures

Figure 1
Figure 1
Mean pain scores after robotic-assisted laparoscopic radical prostatectomy (RALRP) and open radical prostatectomy (ORP) performed at Vanderbilt University (Nashville, TN). POD, postoperative day.
Figure 2
Figure 2
Patient assessment of urinary continence after open radical prostatectomy (ORP).
See this image and copyright information in PMC

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