Laparoscopic and robotic assisted radical prostatectomy--critical analysis of the results.

OBJECTIVE To evaluate the role of laparoscopic radical prostatectomy (LRP) and robotic assisted radical prostatectomy (RLRP) based on personal experience and a review of the literature. MATERIAL AND METHODS Own experience at one European and one American LRP-center includes more than 2000 cases. We performed a MEDLINE search reviewing the literature on LRP and RLRP between 1992 and 2005 with special emphasis on historical aspects, technical considerations, comparison to open retropubic (RRP) and perineal radical prostatectomy (PRP), laparoscopic training, and the cost-efficiency of the techniques. RESULTS Based on sophisticated training programs a continuous dissemination of the technique took place. In the United States, this process was accelerated by the use of the daVinci-robot. There is a trend towards the extraperitoneal access. Mid-term outcomes of LRP achieved equivalence to open surgery with regards to complications, oncologic and functional results. Distinct advantages of LRP include less postoperative pain, lower rate of complications, shorter convalescence, and better cosmesis. In contrast to RLRP, LRP may reach cost-equivalence with open surgery (i.e. by reduction of OR-time, use of multi-usable instruments). CONCLUSIONS LRP reproduces the excellent results of open surgery providing the advantages of minimal access. Video-assisted teaching improves the transfer of anatomical knowledge and technical knowhow. In contrast the United States, the use of robots is likely to remain limited in Europe.

[1]  C. Abbou,et al.  Comparison of early oncologic results of laparoscopic radical prostatectomy by extraperitoneal versus transperitoneal approach. , 2004, European urology.

[2]  Akshay Bhandari,et al.  Vattikuti Institute prostatectomy, a technique of robotic radical prostatectomy for management of localized carcinoma of the prostate: experience of over 1100 cases. , 2004, The Urologic clinics of North America.

[3]  C. Schulman,et al.  Laparoscopic radical prostatectomy: the learning curve , 2005, Current opinion in urology.

[4]  A. Patriciu,et al.  Nerve sparing radical prostatectomy: effects of hemostatic energy sources on the recovery of cavernous nerve function in a canine model. , 2004, The Journal of urology.

[5]  T. Ahlering,et al.  Successful transfer of open surgical skills to a laparoscopic environment using a robotic interface: initial experience with laparoscopic radical prostatectomy. , 2003, The Journal of urology.

[6]  Christian Stock,et al.  Telesurgical Laparoscopic Radical Prostatectomy , 2001, European Urology.

[7]  J. Rassweiler,et al.  Heilbronn Laparoscopic Radical Prostatectomy , 2001, European Urology.

[8]  Adrian Lobontiu,et al.  Laparoscopic radical prostatectomy: description of the extraperitoneal approach using the da Vinci robotic system. , 2003, The Journal of urology.

[9]  Herbert Lepor,et al.  Radical prostatectomy with preservation of sexual function: Anatomical and pathological considerations , 1983, The Prostate.

[10]  A. Zlotta,et al.  Radical prostatectomy: a prospective comparison of oncological and functional results between open and laparoscopic approaches , 2003, World Journal of Urology.

[11]  G Vallancien,et al.  Laparoscopic radical prostatectomy: oncological evaluation after 1,000 cases a Montsouris Institute. , 2003, The Journal of urology.

[12]  J. Binder,et al.  Robotic technology and the translation of open radical prostatectomy to laparoscopy: the early Frankfurt experience with robotic radical prostatectomy and one year follow-up. , 2003, European urology.

[13]  F. Montorsi,et al.  Tadalafil in the treatment of erectile dysfunction following bilateral nerve sparing radical retropubic prostatectomy: a randomized, double-blind, placebo controlled trial. , 2004, The Journal of urology.

[14]  C. Abbou,et al.  Radical prostatectomy by the retropubic, perineal and laparoscopic approach: 12 years of experience in one center. , 2002, European urology.

[15]  M. Coptcoat,et al.  Laparoscopy in Urology , 1994 .

[16]  J. Rassweiler,et al.  Technical evolution of laparoscopic radical prostatectomy after 450 cases. , 2003, Journal of endourology.

[17]  Rosanna Tarricone,et al.  Cost-of-illness analysis. What room in health economics? , 2006, Health policy.

[18]  C. Abbou,et al.  Assessment of surgical technique and perioperative morbidity associated with extraperitoneal versus transperitoneal laparoscopic radical prostatectomy. , 2003, Urology.

[19]  B. Guillonneau,et al.  Perioperative complications of laparoscopic radical prostatectomy: the Montsouris 3-year experience. , 2002, The Journal of urology.

[20]  L. Gomella,et al.  Perioperative morbidity of laparoscopic radical prostatectomy compared with open radical retropubic prostatectomy. , 2004, Urologic oncology.

[21]  J. Kaouk,et al.  Laparoscopic radical prostatectomy: a multi-institutional study of conversion to open surgery. , 2004, Urology.

[22]  C. Zippe,et al.  Laparoscopic radical prostatectomy: technique. , 2001, The Urologic clinics of North America.

[23]  B. Trock,et al.  Classification and trends of perioperative morbidities following laparoscopic radical prostatectomy. , 2005, The Journal of urology.

[24]  James A. Brown,et al.  Transperitoneal versus extraperitoneal approach to laparoscopic radical prostatectomy: an assessment of 156 cases. , 2005, Urology.

[25]  T Frede,et al.  Robotics and telesurgery – an update on their position in laparoscopic radical prostatectomy , 2005, Minimally invasive therapy & allied technologies : MITAT : official journal of the Society for Minimally Invasive Therapy.

[26]  P. Walsh,et al.  Precise localization of the autonomic nerves from the pelvic plexus to the corpora cavernosa: a detailed anatomical study of the adult male pelvis. , 1985, The Journal of urology.

[27]  B. Guillonneau,et al.  Positive surgical margins and accessory pudendal artery preservation during laparoscopic radical prostatectomy. , 2005, European urology.

[28]  J. Smith.  Robotically assisted laparoscopic prostatectomy: an assessment of its contemporary role in the surgical management of localized prostate cancer. , 2004, American journal of surgery.

[29]  Guy Vallancien,et al.  Robotically Assisted Laparoscopic Radical Prostatectomy: Feasibility Study in Men , 2001, European Urology.

[30]  D. Teber,et al.  The effect of previous transperitoneal laparoscopic inguinal herniorrhaphy on transperitoneal laparoscopic radical prostatectomy. , 2005, The Journal of urology.

[31]  M. Moyad.  Heart healthy equals prostate healthy equals statins: the next cancer chemoprevention trial. Part I , 2005, Current opinion in urology.

[32]  A. Omar,et al.  Laparoscopic radical prostatectomy a review of the literature and comparison with open techniques , 2004, Prostate Cancer and Prostatic Diseases.

[33]  J. Rassweiler,et al.  Laparoscopic radical prostatectomy with the Heilbronn technique: an analysis of the first 180 cases. , 2001, The Journal of urology.

[34]  M. Harris.  Radical perineal prostatectomy: cost efficient, outcome effective, minimally invasive prostate cancer management. , 2003, European urology.

[35]  Li-Ming Su,et al.  Nerve-sparing laparoscopic radical prostatectomy: replicating the open surgical technique. , 2004, Urology.

[36]  S. Loening,et al.  Laparoscopic Radical Prostatectomy , 2001, European Urology.

[37]  A. Hoznek,et al.  Laparoscopic Radical Prostatectomy: Preliminary Results , 2000, European Urology.

[38]  Ashutosh Tewari,et al.  Vattikuti Institute prostatectomy: technique. , 2003, The Journal of urology.

[39]  C. Abbou,et al.  Combined reporting of cancer control and functional results of radical prostatectomy. , 2003, European urology.

[40]  H. Miyake,et al.  Comparison of quality of life following laparoscopic and open prostatectomy for prostate cancer. , 2003, The Journal of urology.

[41]  D. Teber,et al.  The Heilbronn laparoscopic training program for laparoscopic suturing: concept and validation. , 2005, Journal of endourology.

[42]  J. Rassweiler,et al.  Laparoscopic radical prostatectomy: prospective evaluation of the learning curve. , 2005, European urology.

[43]  B. Guillonneau,et al.  Laparoscopic radical prostatectomy: the Montsouris experience. , 2000, The Journal of urology.

[44]  C. Stief,et al.  Evolution of endoscopic extraperitoneal radical prostatectomy (EERPE)—technical improvements and development of a nerve-sparing, potency-preserving approach , 2003, World Journal of Urology.

[45]  H. Lepor.  Practical considerations in radical retropubic prostatectomy. , 2003, The Urologic clinics of North America.

[46]  B. Guillonneau,et al.  Laparoscopic radical prostatectomy: the Montsouris technique. , 2000, The Journal of urology.

[47]  M. Kattan,et al.  Risk factors for complications and morbidity after radical retropubic prostatectomy. , 1997, The Journal of urology.

[48]  X. Cathelineau,et al.  Robotic radical prostatectomy: the European experience. , 2004, The Urologic clinics of North America.

[49]  J. Kaouk,et al.  Lateral pedicle control during laparoscopic radical prostatectomy: refined technique. , 2005, Urology.

[50]  R. Rabenalt,et al.  Endoscopic extraperitoneal radical prostatectomy: initial experience after 70 procedures. , 2003, The Journal of urology.

[51]  S. Bhayani,et al.  Prospective comparison of short-term convalescence: laparoscopic radical prostatectomy versus open radical retropubic prostatectomy. , 2003, Urology.

[52]  A. Zlotta,et al.  Extraperitoneal laparoscopic radical prostatectomy. Results after 50 cases. , 2001, European urology.

[53]  G. Janetschek,et al.  980Technique of radical prostatectomy — A head to head comparison of retropubic, perineal and laparoscopic access — Data on perioperative morbidity , 2005 .

[54]  C. Abbou,et al.  Development of laparoscopic surgery and training facilities in Europe: results of a survey of the European Society of Uro-Technology (ESUT). , 2005, European urology.

[55]  S. Değer,et al.  Laparoscopic radical prostatectomy--the experience of the German Laparoscopic Working Group. , 2006, European urology.

[56]  C. Abbou,et al.  Radical retropubic versus laparoscopic prostatectomy: a prospective comparison of functional outcome. , 2003, Urology.

[57]  X. Cathelineau,et al.  Transperitoneal or extraperitoneal approach for laparoscopic radical prostatectomy: a false debate over a real challenge. , 2004, The Journal of urology.

[58]  Ralph V Clayman,et al.  Technique for laparoscopic running urethrovesical anastomosis:the single knot method. , 2003, Urology.

[59]  J. Binder,et al.  Robotically‐assisted laparoscopic radical prostatectomy , 2001, BJU international.

[60]  S. Bhayani,et al.  Health related quality of life before and after laparoscopic radical prostatectomy. Commentary , 2005 .

[61]  J. Rassweiler,et al.  Current laparoscopic practice patterns in urology: results of a survey among urologists in Germany and Switzerland. , 2002, European urology.

[62]  A. Haese*,et al.  Influence of nerve-sparing (NS) procedure during radical prostatectomy (RP) on margin status and biochemical failure. , 2005, European urology.

[63]  C. Abbou,et al.  Laparoscopic radical prostatectomy: a European virus with global potentials. , 2002, Archivos espanoles de urologia.

[64]  H. Klingler,et al.  Morbidity of laparoscopic extraperitoneal versus transperitoneal radical prostatectomy verus open retropubic radical prostatectomy. , 2005, European urology.

[65]  J. Goellner,et al.  Prostate shape, external striated urethral sphincter and radical prostatectomy: the apical dissection. , 1987, The Journal of urology.

[66]  V. Ficarra,et al.  Is laparoscopic radical prostatectomy better than traditional retropubic radical prostatectomy? An analysis of peri-operative morbidity in two contemporary series in Italy. , 2003, European urology.

[67]  M. Zacharias,et al.  [Minimal invasiveness of laparoscopic radical prostatectomy: reality or dream?]. , 2004, Aktuelle Urologie.

[68]  M. Graefen,et al.  Intraoperative and perioperative morbidity of contemporary radical retropubic prostatectomy in a consecutive series of 1243 patients: results of a single center between 1999 and 2002. , 2003, European urology.

[69]  Mani Menon,et al.  Vattikuti Institute prostatectomy: a technique of robotic radical prostatectomy: experience in more than 1000 cases. , 2004, Journal of endourology.

[70]  H. Huland,et al.  Funktionelle Ergebnisse unterschiedlicher Operationstechniken der radikalen Prostatektomie , 2003, Der Urologe, Ausgabe A.

[71]  P. Schellhammer,et al.  Prospective longitudinal comparative study of health-related quality of life in patients undergoing invasive treatments for localized prostate cancer. , 2005, Journal of endourology.

[72]  S. Loening,et al.  Positive margins after laparoscopic radical prostatectomy: a prospective study of 100 cases performed by 4 different surgeons. , 2003, European urology.

[73]  S. Bhayani,et al.  Health related quality of life before and after laparoscopic radical prostatectomy. , 2005, The Journal of urology.

[74]  Ashutosh Tewari,et al.  Laparoscopic and robot assisted radical prostatectomy: establishment of a structured program and preliminary analysis of outcomes. , 2002, The Journal of urology.

[75]  D. Teber,et al.  Laparoscopic radical prostatectomy: functional and oncological outcomes , 2004, Current opinion in urology.

[76]  D. Teber,et al.  Comparison of training modalities for performing laparoscopic radical prostatectomy: experience with 1,000 patients. , 2005, Journal of Urology.

[77]  Ashutosh Tewari,et al.  An operative and anatomic study to help in nerve sparing during laparoscopic and robotic radical prostatectomy. , 2003, European urology.

[78]  Jens Rassweiler,et al.  Robotic and telesurgery: will they change our future? , 2001, Current opinion in urology.

[79]  T Frede,et al.  Transperitoneal laparoscopic radical prostatectomy: ascending technique. , 2004, Journal of endourology.

[80]  A. Haese*,et al.  Indication, Technique and Outcome of Retropubic Nerve-Sparing Radical Prostatectomy , 2005 .

[81]  D. Albala,et al.  Prospective and longitudinal patient self-assessment of health-related quality of life following radical perineal prostatectomy. , 2004, The Journal of urology.

[82]  P. Alken,et al.  The technique of transperitoneal laparoscopic nephrectomy, adrenalectomy and nephroureterectomy. , 1993, European urology.

[83]  Culley Carson,et al.  The role of dihydrotestosterone in benign prostatic hyperplasia. , 2003, Urology.

[84]  L R Kavoussi,et al.  Laparoscopic radical prostatectomy: initial short-term experience. , 1997, Urology.

[85]  R. Hautmann,et al.  [Radical prostatectomy for men aged <56 years with prostate cancer. Cost of illness analysis]. , 2005, Der Urologe. Ausg. A.

[86]  Dogu Teber,et al.  Laparoscopic versus open radical prostatectomy: a comparative study at a single institution. , 2003, The Journal of urology.

[87]  A. Haese*,et al.  Patient-reported sexual function after nerve-sparing radical retropubic prostatectomy. , 2002, European urology.

[88]  Yair Lotan,et al.  The new economics of radical prostatectomy: cost comparison of open, laparoscopic and robot assisted techniques. , 2004, The Journal of urology.

[89]  D. Teber,et al.  Laparoscopic radical prostatectomy with the Heilbronn technique: oncological results in the first 500 patients. , 2005, The Journal of urology.

[90]  J. Binder,et al.  Robotic-assisted laparoscopic radical prostatectomy: the Frankfurt technique , 2003, World Journal of Urology.

[91]  S. Bhayani,et al.  Making ends meet: a cost comparison of laparoscopic and open radical retropubic prostatectomy. , 2004, The Journal of urology.

[92]  H. Zincke,et al.  Potency-Sparing Radical Retropubic Prostatectomy: A Simplified Anatomical Approach , 1995 .

[93]  Guy Vallancien,et al.  Laparoscopic Radical Prostatectomy: Technical and Early Oncological Assessment of 40 Operations , 1999, European Urology.