Die roboterassistierte laparoskopische radikale Prostatektomie

Abstract

Radical prostatectomy aims for optimal tumor control, minimal morbidity, and best functional outcomes of urinary continence and erection. With the introduction of the robotic daVinci surgical system an impressive shift from open radical to robotic laparoscopic prostatectomy (RLP) has occurred especially in the USA. Unfortunately, initial and instrumental costs and maintenance fees of the system are still very high. Compared with the open retropubic approach, RLP has a similar short-term outcome in oncological control, potency, and urinary continence but potentially distinctly favorable benefits in blood loss, transfusion rates, and minor complications. However, RLP is still in its infancy compared to open radical prostatectomy. Inter-institutional trials with the same validated questionnaires are necessary for the future to evaluate oncological and functional results conclusively. The individual surgeon's experience with his routinely preferred technique remains the crucial key for a successful oncological and functional outcome in radical prostatectomy, whatever technology is used.

Contemporary Radical Prostatectomy

“…RALP is rapidly becoming the predominant form of surgical management for prostate cancer in the United States. In 2007, about 60–70% of all radical prostatectomies in the US were performed by assistance of the “da Vinci” surgical system (personal communication, Intuitive Surgical) [24, 25]. Hu et al identified 14,727 men undergoing minimally invasive, perineal, and retropubic RP from 2003 to 2005 using nationally representative, employer-based administrative data.…”