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Updated: Jul 5, 2026
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Retzius-Sparing Robot-Assisted Radical Prostatectomy
Published on: May 19, 2022
Pathologic outcomes during the learning curve for robotic-assisted laparoscopic radical prostatectomy
Amul Shah1, Onisuru T Okotie, Lee Zhao
1Department of Urology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA.
Summary
Robotic-assisted laparoscopic prostatectomy (RALP) shows excellent oncologic outcomes with a shorter learning curve than expected. Positive surgical margin rates were low, even for advanced cancer stages.
Area of Science:
- Urology
- Surgical Oncology
- Robotic Surgery
Background:
- Robotic-assisted laparoscopic prostatectomy (RALP) is increasingly used for radical prostatectomy.
- Concerns exist regarding the learning curve and oncologic outcomes, particularly positive surgical margins, due to lack of tactile feedback.
Purpose of the Study:
- To evaluate the initial experience with RALP, focusing on positive surgical margins.
- To assess the learning curve for RALP in terms of oncologic outcomes.
Main Methods:
- Retrospective review of 62 patients undergoing RALP by a single surgeon.
- Analysis of surgical pathology records for tumor characteristics and margin status.
- All procedures performed using the da Vinci Robotic System.
Main Results:
- Overall positive surgical margin rate was 3.3%.
- For pT2 disease, the positive margin rate was 1.8%; for pT3 disease, it was 16.7%.
- 62.3% of patients had a Gleason score of 7 or greater.
Conclusions:
- RALP can achieve excellent oncologic outcomes, comparable or superior to open radical prostatectomy.
- The learning curve for RALP regarding oncologic outcomes is shorter than anticipated.
- Concerns about tactile feedback negatively impacting outcomes are not supported by this initial experience.