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Robot-assisted versus pure laparoscopic radical prostatectomy

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Abstract

The aim of this study is to report the relative advantages and disadvantages of the radical prostatectomy with a laparoscopic (LRP) and a robotic (RALP) approach. A medline search was performed. Published data regarding perioperative parameters, complications, oncological results, functional results were analyzed. Shorter learning curves have been reported with the RALP. Intra-operative and post-operative outcomes appear to be comparable between the two approaches. The average time for LRP is 234 min (151–453) versus 182 min (141–250) for RALP. Estimated blood loss for the LRP averages 482 ml (185–850) versus 234 ml (75–500) for the RALP. Complication rates in single institution studies are similar. Long-term outcomes data on PSA progression is not yet available for LRP or RALP due to their relatively short existence. RALP appears to offer a significant benefit to the laparoscopically naïve surgeon with respect to learning curve when compared to LRP. This, however, comes at an increased cost. Intra-operative and post-operative outcomes appear to be similar. Longer follow-up data is necessary to compare oncological and functional outcomes.

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References

  1. Schuessler WW, Schulam PG, Clayman RV, Kavoussi LR (1997) Laparoscopic radical prostatectomy: initial short-term experience. Urology 50(6):854–857

    Article  PubMed  CAS  Google Scholar 

  2. Raboy A, Ferzli G, Albert P (1997) Initial experience with extraperitoneal endoscopic radical retropubic prostatectomy. Urology 50(6):849–853

    Article  PubMed  CAS  Google Scholar 

  3. Guillonneau B, Cathelineau X, Barret E, Rozet F, Vallancien G (1999) Laparoscopic radical prostatectomy: technical and early oncological assessment of 40 operations. Eur Urol 36(1):14–20

    Article  PubMed  CAS  Google Scholar 

  4. Guillonneau B, Vallancien G (2000) Laparoscopic radical prostatectomy: the Montsouris technique. J Urol 163(6):1643–1649

    Article  PubMed  CAS  Google Scholar 

  5. Rassweiler J, Seemann O, Schulze M, Teber D, Hatzinger M, Frede T (2003) Laparoscopic versus open radical prostatectomy: a comparative study at a single institution. J Urol 169(5):1689–1693

    Article  PubMed  Google Scholar 

  6. Salomon L, Sebe P, De la Taille A et al (2004) Open versus laparoscopic radical prostatectomy: part I. BJU Int 94(2):238–243

    Article  PubMed  Google Scholar 

  7. Bhayani SB, Pavlovich CP, Hsu TS, Sullivan W, Su LM (2003) Prospective comparison of short-term convalescence: laparoscopic radical prostatectomy versus open radical retropubic prostatectomy. Urology 61(3):612–616

    Article  PubMed  Google Scholar 

  8. Menon M, Tewari A, Peabody J (2003) Vattikuti Institute prostatectomy: technique. J Urol 169(6):2289–2292

    Article  PubMed  Google Scholar 

  9. Vallancien G, Gupta R, Cathelineau X, Baumert H, Rozet F (2003) Initial results of salvage laparoscopic radical prostatectomy after radiation failure. J Urol 170(5):1838–1840

    Article  PubMed  Google Scholar 

  10. Sarle R, Tewari A, Hemal AK, Menon M (2005) Robotic-assisted anatomic radical prostatectomy: technical difficulties due to a large median lobe. Urol Int 74(1):92–94

    Article  PubMed  Google Scholar 

  11. Chang CM, Moon D, Gianduzzo TR, Eden CG (2005) The impact of prostate size in laparoscopic radical prostatectomy. Eur Urol 48(2):285–290

    Article  PubMed  CAS  Google Scholar 

  12. Brown JA, Garlitz C, Strup SE, Hubosky SG, Gomella L (2004) Laparoscopic radical prostatectomy after neoadjuvant hormonal therapy: an apparently safe and effective procedure. J Laparoendosc Adv Surg Tech A 14(6):335–338

    PubMed  Google Scholar 

  13. Guillonneau B, el-Fettouh H, Baumert H et al (2003) Laparoscopic radical prostatectomy: oncological evaluation after 1,000 cases a Montsouris Institute. J Urol 169(4):1261–1266

    Article  PubMed  CAS  Google Scholar 

  14. Parsons JK, Jarrett TJ, Chow GK, Kavoussi LR (2002) The effect of previous abdominal surgery on urological laparoscopy. J Urol 168(6):2387–2390

    Article  PubMed  Google Scholar 

  15. Stolzenburg JU, Anderson C, Rabenalt R, Do M, Ho K, Truss MC (2005) Endoscopic extraperitoneal radical prostatectomy in patients with prostate cancer and previous laparoscopic inguinal mesh placement for hernia repair. World J Urol 27:1–5

    Google Scholar 

  16. Rassweiler J, Sentker L, Seemann O, Hatzinger M, Rumpelt HJ (2001) Laparoscopic radical prostatectomy with the Heilbronn technique: an analysis of the first 180 cases. J Urol 166(6):2101–2108

    Article  PubMed  CAS  Google Scholar 

  17. Roumeguere T, Bollens R, Vanden Bossche M et al (2003) Radical prostatectomy: a prospective comparison of oncological and functional results between open and laparoscopic approaches. World J Urol 20(6):360–366

    PubMed  Google Scholar 

  18. Menon M, Hemal AK (2004) Vattikuti Institute prostatectomy: a technique of robotic radical prostatectomy: experience in more than 1000 cases (discussion 619). J Endourol 18(7):611–619

    Article  PubMed  Google Scholar 

  19. Ahlering TE, Skarecky D, Lee D, Clayman RV (2003) Successful transfer of open surgical skills to a laparoscopic environment using a robotic interface: initial experience with laparoscopic radical prostatectomy. J Urol 170(5):1738–1741

    Article  PubMed  Google Scholar 

  20. Patel VR, Tully AS, Holmes R, Lindsay J (2005) Robotic radical prostatectomy in the community setting: the learning curve and beyond: initial 200 cases. J Urol 174(1):269–272

    Article  PubMed  Google Scholar 

  21. Smith JA Jr, Herrell SD (2005) Robotic-assisted laparoscopic prostatectomy: do minimally invasive approaches offer significant advantages? J Clin Oncol 23(32):8170–8175

    Article  PubMed  Google Scholar 

  22. Hoznek A, Salomon L, Olsson LE et al (2001) Laparoscopic radical prostatectomy. The Creteil experience. Eur Urol 40(1):38–45

    Article  PubMed  CAS  Google Scholar 

  23. Bollens R, Vanden Bossche M, Roumeguere T et al (2001) Extraperitoneal laparoscopic radical prostatectomy. Results after 50 cases. Eur Urol 40(1):65–69

    Article  PubMed  CAS  Google Scholar 

  24. Rozet F, Arroyo C, Cathelineau X, Barret E, Prapotnich D, Vallancien G (2004) Extraperitoneal standard laparoscopic radical prostatectomy (discussion 609–610). J Endourol 18(7):605–609

    Article  PubMed  Google Scholar 

  25. Abbou CC, Hoznek A, Salomon L et al (2001) Laparoscopic radical prostatectomy with a remote controlled robot. J Urol 165(6 Pt 1):1964–1966

    PubMed  CAS  Google Scholar 

  26. Gettman MT, Hoznek A, Salomon L et al (2003) Laparoscopic radical prostatectomy: description of the extraperitoneal approach using the da Vinci robotic system. J Urol 170(2 Pt 1):416–419

    Article  PubMed  Google Scholar 

  27. Cathelineau X, Rozet F, Vallancien G (2004) Robotic radical prostatectomy: the European experience. Urol Clin North Am 31(4):693–699, viii

    Google Scholar 

  28. Salomon L, Levrel O, de la Taille A et al (2002) Radical prostatectomy by the retropubic, perineal and laparoscopic approach: 12 years of experience in one center (discussion 110–101). Eur Urol 42(2):104–110

    PubMed  Google Scholar 

  29. Webster TM, Herrell SD, Chang SS et al (2005) Robotic assisted laparoscopic radical prostatectomy versus retropubic radical prostatectomy: a prospective assessment of postoperative pain (discussion 914). J Urol 174(3):912–914

    Article  PubMed  Google Scholar 

  30. Menon M, Tewari A, Baize B, Guillonneau B, Vallancien G (2002) Prospective comparison of radical retropubic prostatectomy and robot-assisted anatomic prostatectomy: the Vattikuti Urology Institute experience. Urology 60(5):864–868

    Article  PubMed  Google Scholar 

  31. Tewari A, Srivasatava A, Menon M (2003) A prospective comparison of radical retropubic and robot-assisted prostatectomy: experience in one institution. BJU Int 92(3):205–210

    Article  PubMed  CAS  Google Scholar 

  32. Guillonneau B, Rozet F, Barret E, Cathelineau X, Vallancien G (2001) Laparoscopic radical prostatectomy: assessment after 240 procedures. Urol Clin North Am 28(1):189–202

    Article  PubMed  CAS  Google Scholar 

  33. Martina GR, Giumelli P, Scuzzarella S, Remotti M, Caruso G, Lovisolo J (2005) Laparoscopic extraperitoneal radical prostatectomy: learning curve of a laparoscopy-naive urologist in a community hospital. Urology 65(5):959–963

    Article  PubMed  CAS  Google Scholar 

  34. Poulakis V, Dillenburg W, Moeckel M et al (2005) Laparoscopic radical prostatectomy: prospective evaluation of the learning curve. Eur Urol 47(2):167–175

    Article  PubMed  Google Scholar 

  35. Menon M, Shrivastava A, Tewari A et al (2002) Laparoscopic and robot assisted radical prostatectomy: establishment of a structured program and preliminary analysis of outcomes. J Urol 168(3):945–949

    Article  PubMed  Google Scholar 

  36. Lee DI, Eichel L, Skarecky DW, Ahlering TE (2004) Robotic laparoscopic radical prostatectomy with a single assistant. Urology 63(6):1172–1175

    Article  PubMed  Google Scholar 

  37. Tewari A, Peabody JO, Fischer M et al (2003) An operative and anatomic study to help in nerve sparing during laparoscopic and robotic radical prostatectomy. Eur Urol 43(5):444–454

    Article  PubMed  Google Scholar 

  38. Lotan Y, Cadeddu JA, Gettman MT (2004) The new economics of radical prostatectomy: cost comparison of open, laparoscopic and robot assisted techniques. J Urol 172(4 Pt 1):1431–1435

    Article  PubMed  Google Scholar 

  39. Scales CD Jr, Jones PJ, Eisenstein EL, Preminger GM, Albala DM (2005) Local cost structures and the economics of robot assisted radical prostatectomy. J Urol 174(6):2323–2329

    Article  PubMed  Google Scholar 

  40. Steers WD, LeBeau S, Cardella J, Fulmer B (2004) Establishing a robotics program. Urol Clin North Am 31(4):773–780, x

    Google Scholar 

  41. Menon M, Shrivastava A, Tewari A (2005) Laparoscopic radical prostatectomy: conventional and robotic. Urology 66(5 Suppl):101–104

    Article  PubMed  Google Scholar 

  42. Stolzenburg JU, Rabenalt R, Do M et al (2005) Endoscopic extraperitoneal radical prostatectomy: oncological and functional results after 700 procedures (discussion 1275). J Urol 174(4 Pt 1):1271–1275

    Article  PubMed  Google Scholar 

  43. Rozet F, Galiano M, Cathelineau X, Barret E, Cathala N, Vallancien G (2005) Extraperitoneal laparoscopic radical prostatectomy: a prospective evaluation of 600 cases. J Urol 174(3):908–911

    Article  PubMed  Google Scholar 

  44. Brown JA, Rodin D, Lee B, Dahl DM (2005) Transperitoneal versus extraperitoneal approach to laparoscopic radical prostatectomy: an assessment of 156 cases. Urology 65(2):320–324

    Article  PubMed  Google Scholar 

  45. Ruiz L, Salomon L, Hoznek A et al (2004) Comparison of early oncologic results of laparoscopic radical prostatectomy by extraperitoneal versus transperitoneal approach (discussion 54–56). Eur Urol 46(1):50–54

    Article  PubMed  Google Scholar 

  46. Eden CG, King D, Kooiman GG, Adams TH, Sullivan ME, Vass JA (2004) Transperitoneal or extraperitoneal laparoscopic radical prostatectomy: does the approach matter? J Urol 172(6 Pt 1):2218–2223

    Article  PubMed  CAS  Google Scholar 

  47. Gregori A, Simonato A, Lissiani A, Bozzola A, Galli S, Gaboardi F (2003) Laparoscopic radical prostatectomy: perioperative complications in an initial and consecutive series of 80 cases (discussion 194). Eur Urol 44(2):190–194

    Article  PubMed  Google Scholar 

  48. Hara I, Kawabata G, Miyake H et al (2002) Feasibility and usefulness of laparoscopic radical prostatectomy: Kobe University experience. Int J Urol 9(11):635–640

    Article  PubMed  Google Scholar 

  49. Turk I, Deger S, Winkelmann B, Schonberger B, Loening SA (2001) Laparoscopic radical prostatectomy. Technical aspects and experience with 125 cases (discussion 53). Eur Urol 40(1):46–52

    Article  PubMed  CAS  Google Scholar 

  50. Menon M, Tewari A (2003) Robotic radical prostatectomy and the Vattikuti Urology Institute technique: an interim analysis of results and technical points. Urology 61(4 Suppl 1):15–20

    Article  PubMed  Google Scholar 

  51. Wolfram M, Brautigam R, Engl T et al (2003) Robotic-assisted laparoscopic radical prostatectomy: the Frankfurt technique. World J Urol 21(3):128–132

    Article  PubMed  CAS  Google Scholar 

  52. Remzi M, Klingler HC, Tinzl MV et al (2005) Morbidity of laparoscopic extraperitoneal versus transperitoneal radical prostatectomy versus open retropubic radical prostatectomy (discussion 89). Eur Urol 48(1):83–89

    Article  PubMed  CAS  Google Scholar 

  53. Joseph JV, Vicente I, Madeb R, Erturk E, Patel HR (2005) Robot-assisted vs pure laparoscopic radical prostatectomy: are there any differences? BJU Int 96(1):39–42

    Article  PubMed  Google Scholar 

  54. Guillonneau B, Cathelineau X, Doublet JD, Baumert H, Vallancien G (2002) Laparoscopic radical prostatectomy: assessment after 550 procedures. Crit Rev Oncol Hematol 43(2):123–133

    Article  PubMed  Google Scholar 

  55. Cathelineau X, Cahill D, Widmer H, Rozet F, Baumert H, Vallancien G (2004) Transperitoneal or extraperitoneal approach for laparoscopic radical prostatectomy: a false debate over a real challenge. J Urol 171(2 Pt 1):714–716

    Article  PubMed  CAS  Google Scholar 

  56. Trabulsi EJ, Guillonneau B (2005) Laparoscopic radical prostatectomy. J Urol 173(4):1072–1079

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Urology, Institut Montsouris, 42 bd Jourdan, 75014, Paris, France

    Francois Rozet, Justin Harmon, Xavier Cathelineau, Eric Barret & Guy Vallancien

  2. Université René Descartes, Paris 5, France

    Francois Rozet, Justin Harmon, Xavier Cathelineau, Eric Barret & Guy Vallancien

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  1. Francois Rozet
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  2. Justin Harmon
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  3. Xavier Cathelineau
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  4. Eric Barret
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  5. Guy Vallancien
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Correspondence to Francois Rozet.

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Rozet, F., Harmon, J., Cathelineau, X. et al. Robot-assisted versus pure laparoscopic radical prostatectomy. World J Urol 24, 171–179 (2006). https://doi.org/10.1007/s00345-006-0065-3

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  • DOI: https://doi.org/10.1007/s00345-006-0065-3

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