Prostate news article, January 2005
| LAPAROSCOPIC
AND ROBOTIC RADICAL PROSTATECTOMY : WHAT ARE THE REAL ADVANTAGES
?
J. Smith Vanderbilt University Medical Center, Deptartment of Urologic Surgery, Nashville, TN, USA. Reviewed by: Mr Zach Dovey, MRCP FRCS |
A recent article in the British Journal of Urology (International) is very interesting in that it summarises the experience of this department in over 250 cases of robotic keyhole (laparoscopic) surgery for removal of the prostate in prostate cancer.
This is compared with the more traditional approach of radical prostatectomy where the prostate is removed through an incision in the lower abdomen.
They stress at the outset that open radical prostatectomy sets a very high standard with, nowdays, a short hospital stay (some patients going home the day after surgery), minimal blood loss (blood transfusion required in < 1% of patients) and very little in the way of postoperative pain. However, using these parameters, after 250 cases, they found that robotic keyhole prostatectomy produced similarly effective results.
In terms of the complications of robotic prostatectomy they suggest theoretical advantages related to the superb visualisation of the operative field on camera, minimal traction of the blood vessels and nerves during surgery and the precision with which cutting and suturing can be performed. This they hope will produce better tumour excision (i.e. better tumour margins), and lower rates of postoperative incontinence and impotence. As yet they don't feel they have enough data to draw any firm conclusions but they hope to be providing positive reports in the future.
Basically - WATCH THIS SPACE !!