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Hayes et al. Mini-invasive Surg 2021;5:56 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2021.126

Perspective Open Access

Has robotic prostatectomy determined the fall of the

laparoscopic approach?

1,2
1
John Hayes , Nikhil Vasdev , Prokar Dasgupta 3
1
Hertfordshire and Bedfordshire Urological Cancer Centre, Lister Hospital, Stevenage SG1 4AB, UK.
2
School of Medicine and Life Sciences, University of Hertfordshire, Hatfield AL10 9EU, UK.
3
Faculty of Life Sciences and Medicine, King’s College London, London WC2R 2LS, UK.
Correspondence to: Dr. Nikhil Vasdev, Hertfordshire and Bedfordshire Urological Cancer Centre, Lister Hospital, Stevenage SG1
4AB, UK. E-mail: nikhil.vasdev@nhs.net
How to cite this article: Hayes J, Vasdev N, Dasgupta P. Has robotic prostatectomy determined the fall of the laparoscopic
approach? Mini-invasive Surg 2021;5:56. https://dx.doi.org/10.20517/2574-1225.2021.126
Received: 3 Nov 2021 First Decision: 24 Nov 2021 Revised: 3 Dec 2021 Accepted: 14 Dec 2021 Published: 25 Dec 2021

Academic Editors: Enrico Checcucci, Riccardo Autorino Copy Editor: Xi-Jun Chen Production Editor: Xi-Jun Chen

Abstract
Robotic-assisted laparoscopic prostatectomy (RALP) has revolutionised the surgical management of localised
prostate cancer in the modern era. The surgeon is provided with greater precision, more versatile dexterity and an
immersive three-dimensional visual field. The impressive hardware facilitates, for example, the dissection of the
peri-prostatic fascia, whilst preserving the neurovascular bundle, or the suturing of the vesico-urethral
anastomosis. Prior to RALP, laparoscopic radical prostatectomy (LRP) represented the first venture into the
minimally invasive world. Associated with more cumbersome ergonomics, LRP has a significant learning curve
compared with the robotic approach. There has been a paucity, until recently, of high-quality literature comparing
outcomes between the two operations, including the attainment of the Pentafecta of survivorship: biochemical
recurrence-free, continence, potency, no postoperative complications and negative surgical margins.

Keywords: Prostate cancer, robotic, prostatectomy, laparoscopic

Today, the majority of men with intermediate or high-risk localised prostate cancer, who are candidates for
surgical intervention, will undergo a robotic-assisted laparoscopic prostatectomy (RALP). The robot has
firmly cemented itself as the modality of choice for both patients and urologists.

© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
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