Abstract
To review the current status of laparoscopic radical prostatectomy (LRP) and robotic assisted radical prostatectomy (RALP) in relation to radical retropubic prostatectomy (RRP) in the management of localized prostate cancer. Between 1982 and 2007 published literature was reviewed using the National Library of Medicine database and the following key words: retropubic, laparoscopic, robotic, robot-assisted, and radical prostatectomy. Special emphasis was given to the technical and cost considerations as well as operative, functional and oncologic outcomes. In particular, reports with pioneering work that have contributed to the evolution of the technique, presenting comparative outcomes and with large series encompassing intermediate/long term follow-up, were taken into account. After intermediate term follow-up, LRP and RALP achieved similar oncologic and functional results compared to RRP. However, LRP and RALP were associated with decreased blood loss, faster convalescence and better cosmetics when compared to RRP. The RALP technique is undoubtedly more expensive. The oncologic and functional outcomes for LRP and RALP are similar to RRP after intermediate term follow-up. Long term follow-up and adequately designed studies will determine the inherent advantages and disadvantages of the individual techniques in the management of localized prostate cancer.
Highlights
To review the current status of laparoscopic radical prostatectomy (LRP) and robotic assisted radical prostatectomy (RALP) in relation to radical retropubic prostatectomy (RRP) in the management of localized prostate cancer
Based on excellent survival rates, radical prostatectomy is considered the standard treatment for the management of localized prostate cancer [2]
Despite only intermediate term follow-up being available for LRP and RALP techniques, current available data demonstrates that laparoscopic and robotic prostatectomy procedures achieve oncologic and functional outcomes similar to the well established technique of open radical prostatectomy
Summary
Prostate cancer accounts for approximately one third of cancer in men in the United States. In addition to the conventional advantages of minimal invasive surgery and reduced blood loss, the LRP technique, in expert hands, is safe and effective, and provides oncologic outcomes comparable to that of open RRP [7,8]. In another study by Ahlering et al, the positive surgical margin rate was 20% for RRP vs 16.7% for RALP [28] None of these comparative studies showed any disadvantage in terms of oncologic outcomes for the minimally invasive approaches. When the ability to perform sexual intercourse after a nerve sparing procedure was compared between the RRP and LRP, similar results, overall, were found [14] After stratifying these patients according to age and unilateral or bilateral nerve-sparing. The RALP technique will certainly need a substantial decrease in the cost of the robotic system and other relevant robotic instruments as well as maintenance fees in order to achieve wider global acceptance and application
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
