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Abstract

Volume 11, Issue 1 (January 2009) 11, 90–93; 10.1038/aja.2008.11

The current status of robot-assisted radical prostatectomy

Prokar Dasgupta1,2 and Roger S. Kirby2

1 Department of Urology, Guy’s and St. Thomas’ Hospitals and King’s College London, School of Medicine, London SE1 9RT, UK
2 The Prostate Centre, London W1G 8GT, UK

Correspondence: Mr Prokar Dasgupta, E-mail: prokarurol@gmail.com

Received 22 September 2008; Accepted 22 September 2008; Published online 1 December 2008

Abstract

Robot-assisted radical prostatectomy (RARP) is a rapidly evolving technique for the treatment of localized prostate cancer. In the United States, over 65% of radical prostatectomies are robot-assisted, although the acceptance of this technology in Europe and the rest of the world has been somewhat slower. This article reviews the current literature on RARP with regard to oncological, continence and potency outcomes–the so-called 'trifecta'. Preliminary data appear to show an advantage of RARP over open prostatectomy, with reduced blood loss, decreased pain, early mobilization, shorter hospital stay and lower margin rates. Most studies show good postoperative continence and potency with RARP; however, this needs to be viewed in the context of the paucity of randomized data available in the literature. There is no definitive evidence to show an advantage over standard laparoscopy, but the fact that this technique has reached parity with laparoscopy within 5 years is encouraging. Finally, evolving techniques of single-port robotic prostatectomy, laser-guided robotics, catheter-free prostatectomy and image-guided robotics are discussed.

Keywords: da Vinci robot, prostate cancer, robot-assisted radical prostatectomy

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