Robotic radical prostatectomy for prostate cancer has similar or better outcomes than open surgery
This review article compares functional and oncological outcomes for open, laparoscopic and robotic prostatectomy for prostate cancer. It appraises 30 articles from high volume centers with a minimum reported 250 cases. There remain no direct head-to-head comparisons of these techniques. However the robotic operation has much less blood loss, almost no blood transfusion requirement, shorter hospital stays and often being sent home the following day, much earlier return to urinary control than open surgery, similar cancer outcomes in terms of positive surgical margin rates, earlier return to normal activities and slightly better erectile function outcomes. The robotic surgery outcomes as compared to the open surgery outcomes were:
- Cancer control, positive surgical margin rate: 13.6% (robotic) v 24%
- 12 month urinary control: 92% (robotic) v 79%
- 12 month erection function: 60-93% (robotic) v 43-60%.
However the learning curve related to becoming proficient in robotic surgery takes time and during this learning phase careful selection of cases must be adhered to for best outcomes.