Open versus robotic radical prostatectomy: a prospective analysis based on a single surgeon's experience

Area of Science:

• Urology
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Prospective comparison of open prostatectomy (OP) and robotic prostatectomy (RP) outcomes.
• Study conducted by a single surgeon with extensive experience.
• Analysis of oncological and functional results over a 5-year period.

Purpose of the Study:

• To compare oncological and functional outcomes between OP and RP.
• To evaluate the learning curve effect on outcomes for both procedures.
• To assess the impact of surgical approach on patient recovery and quality of life.

Main Methods:

• Prospective study of 422 patients undergoing radical prostatectomy (OP: 199, RP: 223).
• Patients categorized into early and late phases for both OP and RP groups.
• Functional outcomes assessed via validated patient questionnaires.

Main Results:

• Robotic prostatectomy (RP) groups showed lower estimated blood loss, shorter hospital stays, and reduced bladder catheterization duration compared to OP.
• RP demonstrated a significantly lower rate of intraoperative complications in later cases (RP-II).
• Positive surgical margin rates were similar or lower in RP-II compared to OP, especially for T2 and T3 stages. Continence and potency recovery were better in RP-II patients, particularly those aged 60 and above.

Conclusions:

• Robotic prostatectomy (RP) by an experienced surgeon yields oncological results comparable or superior to open prostatectomy (OP).
• RP is associated with improved functional outcomes, including shorter recovery times and better functional recovery.
• The findings support RP as a viable alternative to OP, offering potential benefits in patient recovery and quality of life.