Yonsei Med J.  2009 Apr;50(2):177-181.

Robotic Prostatectomy: What We Have Learned and Where We Are Going

• Lee DI

Abstract

Radical prostatectomy became a mainstay of treatment for prostate cancer in the United States after the pioneering work of Walsh in defining the nerve sparing technique. Efforts to reproduce this operation in a minimally invasive fashion resulted in slow progress that recently have flourished with the application of the daVinci Surgical System (Intuitive Surgical, Sunnyvale, CA, USA) by Menon and colleagues. This article summarizes the origins of robotic prostatectomy, some of the current data regarding this operation and potential future directions.

Keyword

Robotic surgery; prostatectomy; prostate cancer; minimally invasive surgery; laparoscopy

MeSH Terms

Humans
Male
Prostatectomy/*methods
Prostatic Neoplasms/*surgery
*Robotics
Surgical Procedures, Minimally Invasive/*methods

Figure

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  Fig. 1 Photograph of laparoscopic stapler placed across the dorsal venous complex.

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  Fig. 2 The right neurovascular bundle is being dissected away from the prostate in an interfascial technique.

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  Fig. 3 View of the apposition of the bladder to the urethra during vanVelthoven anastomosis.

Reference

1. Abbou CC, Hoznek A, Salomon L, Lobontiu A, Saint F, Cicco A, et al. [Remote laparoscopic radical prostatectomy carried out with a robot. Report of a case]. Prog Urol. 2000. 10:520–523.

2. Young HH. The early diagnosis and radical cure of carcinoma of the prostate. Being a study of 40 cases and presentation of a radical operation which was carried out in four cases. 1905. J Urol. 2002. 167:939–946. discussion 947.

3. Millin T. Retropubic prostatectomy. J Urol. 1948. 59:267–280.

4. Walsh PC, Lepor H, Eggleston JC. Radical prostatectomy with preservation of sexual function: anatomical and pathological considerations. Prostate. 1983. 4:473–485.

5. Clayman RV, Kavoussi LR, Soper NJ, Dierks SM, Merety KS, Darcy MD, et al. Laparoscopic nephrectomy. N Engl J Med. 1991. 324:1370–1371.

6. Dunn MD, Portis AJ, Shalhav AL, Elbahnasy AM, Heidorn C, McDougall EM, et al. Laparoscopic versus open radical nephrectomy: a 9-year experience. J Urol. 2000. 164:1153–1159.

7. Chan DY, Cadeddu JA, Jarrett TW, Marshall FF, Kavoussi LR. Laparoscopic radical nephrectomy: cancer control for renal cell carcinoma. J Urol. 2001. 166:2095–2099. discussion 2099-100.

8. Schuessler WW, Schulam PG, Clayman RV, Kavoussi LR. Laparoscopic radical prostatectomy: initial short-term experience. Urology. 1997. 50:854–857.

9. Guillonneau B, Vallancien G. Laparoscopic radical prostatectomy: the Montsouris technique. J Urol. 2000. 163:1643–1649.

10. Kavoussi LR. Laparoscopic radical prostatectomy: irrational exuberance? Urology. 2001. 58:503–505.

11. Menon M, Shrivastava A, Tewari A, Sarle R, Hemal A, Peabody JO, et al. Laparoscopic and robot assisted radical prostatectomy: establishment of a structured program and preliminary analysis of outcomes. J Urol. 2002. 168:945–949.

12. Menon M, Tewari A, Peabody JO, Shrivastava A, Kaul S, Bhandari A, et al. Vattikuti Institute prostatectomy, a technique of robotic radical prostatectomy for management of localized carcinoma of the prostate: experience of over 1100 cases. Urol Clin North Am. 2004. 31:701–717.

13. Badani KK, Kaul S, Menon M. Evolution of robotic radical prostatectomy: assessment after 2766 procedures. Cancer. 2007. 110:1951–1958.

14. Perer E, Lee DI, Ahlering T, Clayman RV. Robotic revelation: laparoscopic radical prostatectomy by a nonlaparoscopic surgeon. J Am Coll Surg. 2003. 197:693–696.

15. Ahlering TE, Eichel L, Edwards RA, Lee DI, Skarecky DW. Robotic radical prostatectomy: a technique to reduce pT2 positive margins. Urology. 2004. 64:1224–1228.

16. Nelson B, Kaufman M, Broughton G, Cookson MS, Chang SS, Herrell SD, et al. Comparison of length of hospital stay between radical retropubic prostatectomy and robotic assisted laparoscopic prostatectomy. J Urol. 2007. 177:929–931.

17. Farnham SB, Webster TM, Herrell SD, Smith JA Jr. Intraoperative blood loss and transfusion requirements for robotic-assisted radical prostatectomy versus radical retropubic prostatectomy. Urology. 2006. 67:360–363.

18. Smith JA Jr, Chan RC, Chang SS, Herrell SD, Clark PE, Baumgartner R, et al. A comparison of the incidence and location of positive surgical margins in robotic assisted laparoscopic radical prostatectomy and open retropubic radical prostatectomy. J Urol. 2007. 178:2385–2389. discussion 2389-90.

19. Eastham JA, Kattan MW, Riedel E, Begg CB, Wheeler TM, Gerigk C, et al. Variations among individual surgeons in the rate of positive surgical margins in radical prostatectomy specimens. J Urol. 2003. 170:2292–2295.

20. Klein EA, Bianco FJ, Serio AM, Eastham JA, Kattan MW, Pontes JE, et al. Surgeon experience is strongly associated with biochemical recurrence after radical prostatectomy for all preoperative risk categories. J Urol. 2008. 179:2212–2216. discussion 2216-7.

21. Van Velthoven RF, Ahlering TE, Peltier A, Skarecky DW, Clayman RV. Technique for laparoscopic running urethrovesical anastomosis: the single knot method. Urology. 2003. 61:699–702.

22. Savera AT, Kaul S, Badani K, Stark AT, Shah NL, Menon M. Robotic radical prostatectomy with the "Veil of Aphrodite" technique: histologic evidence of enhanced nerve sparing. Eur Urol. 2006. 49:1065–1073. discussion 1073-4.

23. Gettman MT, Lotan Y, Napper CA, Cadeddu JA. Transvaginal laparoscopic nephrectomy: development and feasibility in the porcine model. Urology. 2002. 59:446–450.

24. Kaouk JH, Goel RK, Haber GP, Crouzet S, Desai MM, Gill IS. Single-port laparoscopic radical prostatectomy. Urology. 2008. 72:1190–1193.

25. Boyette LB, Reardon MA, Mirelman AJ, Kirkley TD, Lysiak JJ, Tuttle JB, et al. Fiberoptic imaging of cavernous nerves in vivo. J Urol. 2007. 178:2694–2700.