- Benign Prostatic Hyperplasia
- Bladder Conditions
- Male Infertility
- Pediatric Urology
- Sexual Dysfunction
- Stone Management and Endourology
- Urinary Tract Conditions
Robot-assisted Extraperitoneal Laparoscopic Radical Prostatectomy โ A Review of the Current Literature
European Urological Review, 2010;5(1):15-8
Prostate cancer is the most commonly detected male cancer and the second leading cause of male cancer deaths in the US and Europe.1 Its prognosis is directly related to stage at diagnosis and treatment. With the widespread diffusion of screening for prostate cancer, the disease has been diagnosed more commonly in the organ-confined stage and in younger and healthier men.2
Conventional treatment options include radical prostatectomy (RP), external-beam radical radiotherapy, brachytherapy and active surveillance with or without regular biopsy.3 More recently, focal therapies such as cryoablation and high-intensity focused ultrasound have been introduced, but their oncological effectiveness remains uncertain. RP is an established and accepted treatment for localised and, more recently, locally advanced prostate cancer.
Overall 10-year prostate-specific androgen (PSA) progression rates after RP are around 30%.3 Recurrence rates are increased in men with a higher pre-operative PSA, Gleason grade or tumour stage and where there are positive margins in the pathological specimen.
In an effort to further decrease the morbidity of open RP, a minimally invasive surgical approach to treating prostate cancer was first described by Schuessler et al. in 1997.4 These authors performed the first successful laparoscopic RP (LRP). From their initial experience, the authors noted the challenging nature of LRP, with long operative times and hospital stays. Although cancer cure with LRP was deemed similar to that with RP, the authors concluded that LRP offered no significant advantage over RP. LRP was revived only in the late 1990s, as European surgeons re-evaluated it and reported feasibility with excellent operative outcomes.5โ8 However, the technical demands of the surgery and the important learning curve have prevented the widespread adoption of LRP by most urological surgeons. Specifically, the reduction in the range of motion, 2D vision, counterintuitive handโeye co-ordination between real and visible movements and the reduced haptic sense are the main obstacles associated with a long learning curve.
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- Heidenreich A, Aus G, Bolla M, et al., European Association of Urology, EAU guidelines on prostate cancer, Eur Urol, 2008;53(1):68โ80.
- Schuessler WW, Schulam PG, Clayman RV, et al., Laparoscopic radical prostatectomy: initial short-term experience, Urology, 1997;50:854โ7.
- Guillonneau B, Vallancien G, Laparoscopic radical prostatectomy: the Montsouris experience, J Urol, 2000;163:418โ22.
- Abbou CC, Salomon L, Hoznek A, et al., Laparoscopic radical prostatectomy: preliminary results, Urology, 2000;55(5):630โ34.
- Rassweiler J, Sentker L, Seemann O, et al., Laparoscopic radical prostatectomy with the Heilbronn technique. An analysis of the first 180 cases, J Urol, 2001;166:2101โ8.
- Eden CG, Cahill D, Vass JA, et al., Laparoscopic radical prostatectomy: the initial UK series, BJU Int, 2002;90: 876โ82.
- Binder J, Kramer W, Robotically-assisted laparoscopic radical prostatectomy, BJU Int, 2001;87:408โ10.
- Joseph JV, Rosenbaum R, Madeb R, et al., Robotic extraperitoneal radical prostatectomy: an alternative approach, J Urol, 2006;175(3 Pt 1):945โ50.
- Rozet F, Jaffe J, Braud G, et al., A direct comparison of robotic assisted versus pure laparoscopic radical prostatectomy: a single institution experience, J Urol, 2007;178(2):478โ82.
- Ploussard G, Xylinas E, Salomon L, et al., Robot-assisted extraperitoneal laparoscopic radical prostatectomy: experience in a high-volume laparoscopy reference centre, BJU Int, 2010;105:1155โ60.
- Badani KK, Kaul S, Menon M, Evolution of robotic radical prostatectomy: assessment after 2766 procedures, Cancer, 2007;110:1951โ8.
- Swindle P, Eastham JA, Ohori M, et al., Do margins matter? The prognostic significance of positive surgical margins in radical prostatectomy specimens, J Urol, 2005;174(3):903โ7.
- Patel VR, Thaly R, Shah K, Robotic radical prostatectomy: outcomes of 500 cases, BJU Int, 2007;99:1109โ12.
- Madeb R, Golijanin D, Knopf J, et al., Patient-reported validated functional outcome after extraperitoneal robotic-assisted nerve-sparing radical prostatectomy, JSLS, 2007;11(3):315โ20.
- Xylinas E, Ploussard G, Paul A, et al., Intrafascial nervesparing laparoscopic robot-assisted extraperitoneal radical prostatectomy: early oncological and functional results, J Endourol, 2010;24(4):577โ82.
- Tewari A, Jhaveri J, Rao S, et al., Total reconstruction of the vesico-urethral junction, BJU Int, 2008;101:871โ7.
- Rocco F, Carmignani L, Acquati P, et al., Restoration of posterior aspect of rhabdosphincter shortens continence time after radical retropubic prostatectomy, J Urol, 2006;175:2201โ6.
- Rocco B, Gregori A, Stener S, et al., Posterior reconstruction of the rhabdosphincter allows a rapid recovery of continence after transperitoneal videolaparoscopic radical prostatectomy, Eur Urol, 2007;51:996โ1003.
- Coughlin G, Dangle PP, Patil NN, et al., Surgery Illustrated โ focus on details. Modified posterior reconstruction of the rhabdosphincter: application to roboticassisted laparoscopic prostatectomy, BJU Int, 2008;102:1482โ5.
- Patel VR, Coelho RF, Palmer KJ, et al., Periurethral suspension stitch during robotic-assisted laparoscopic radical prostatectomy. Description of the technique and continence outcomes, Eur Urol, 2009;56:472โ8.
- Menon M, Muhletaler F, Campos M, et al., Assessment of early continence after reconstruction of the periprostatic tissues in patients undergoing computer assisted (robotic) prostatectomy: results of a 2 group parallel randomized controlled trial, J Urol, 2008;180:1018โ23.
- Ploussard G, Xylinas E, Paul A, et al., Does robotic assistance increased operating room time compared to pure retroperitoneal laparoscopic radical prostatectomy?, J Endourol, 2009;23(6):939โ43.
- Vickers AJ, Savage CJ, Hruza M, et al., The surgical learning curve for laparoscopic radical prostatectomy: a retrospective cohort study, Lancet Oncol, 2009;10:475โ80.
- Menon M, Shrivastava A, Tewari A, et al., Laparoscopic and robot assisted radical prostatectomy: establishment of a structured program and preliminary analysis of outcomes, J Urol, 2002;168(3):945โ9.
- Ahlering TE, Skarecky D, Lee D, et al., Successful transfer of open surgical skills to a laparoscopic environment using a robotic interface: initial experience with laparoscopic radical prostatectomy, J Urol, 2003;170: 1738โ41.
- Artibani W, Fracalanza S, Cavalleri S, et al., Learning curve and preliminary experience with da Vinci-assisted laparoscopic radical prostatectomy, Urol Int, 2008;80: 237โ44.
- Menon M, Tewari A, Peabody J, Vattikuti Institute prostatectomy: technique, J Urol, 2003;169:2289โ92.
- Zorn KC, Orvieto MA, Gong EM, et al., Robotic radical prostatectomy learning curve of a fellowship-trained laparoscopic surgeon, J Endourol, 2007;21:441โ7.
- Mikhail AA, Orvieto MA, Billatos ES, et al., Roboticassisted laparoscopic prostatectomy: first 100 patients with one year of follow-up, Urology, 2006;68:1275โ9.
- Kaul SA, Peabody JO, Shah N, et al., Establishing a robotic prostatectomy programme: the impact of mentoring using a structured approach, BJU Int, 2006;97:1143โ4.
- Madi R, Daignault S, Wood DP, Extraperitoneal v intraperitoneal robotic prostatectomy: analysis of operative outcomes, J Endourol, 2007;21(12):1553โ7.
- Atug F, Castle EP, Woods M, et al., Transperitoneal versus extraperitoneal robotic-assisted radical prostatectomy: is one better than the other?, Urology, 2006;68(5):1077โ81.
- Burgess SV, Atug F, Castle EP, et al., Cost analysis of radical retropubic, perineal, and robotic prostatectomy, J Endourol, 2006;20(10):827โ30.
- Kaouk JH, Goel RK, Haber GP, et al., Single-port laparoscopic radical prostatectomy, Urology, 2008;72(6): 1190โ93.
- Barret E, Sanchez-Salas R, Kasraeian A, et al., A transition to laparoendoscopic single-site surgery (LESS) radical prostatectomy: human cadaver experimental and initial clinical experience, J Endourol, 2009;23(1):135โ40.