Witnessing the Transition of Open to Robotic Surgery

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A paradigm shift has occurred in urologic surgery over the past 2 decades. Whereas the guiding principle of surgery – exposure – was formerly envisioned as a larger incision, it is now conceptualized as a video monitor, a laparoscope, and well-positioned trocars. In its infancy, basic diagnostic and extirpative laparoscopy demonstrated substantial clinical advantages over open surgery and introductory laparoscopic skills proved to be readily transferable. However, with more complex reconstructive laparoscopic procedures in urology, a steep learning curve has impeded widespread progress. In the context of this surgical transition, robotic technology is now playing a defining role, facilitating dissemination of increasingly complex laparoscopic procedures in urology.