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ISRN Oncology
Volume 2013 (2013), Article ID 768647, 8 pages
http://dx.doi.org/10.1155/2013/768647
Clinical Study

Does Changeover by an Experienced Open Prostatic Surgeon from Open Retropubic to Robot-Assisted Laparoscopic Prostatectomy Mean a Step Forward or Backward?

1Department of Urology, Pediatric Urology and Urologic Oncology, Kliniken Essen-Mitte, Henricistraβe 92, 45136 Essen, Germany
2Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Hufelandstraβe 55, 45122 Essen, Germany
3Die Gesundheitsunion, Urology Health Center, Alter Markt 5-7, 42275 Wuppertal, Germany

Received 19 December 2012; Accepted 9 January 2013

Academic Editors: J. Bentel, Z. S. Guo, R. Nahta, D. Peng, and R. V. Sionov

Copyright © 2013 Michael Musch et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

We assessed whether changeover from open retropubic [RRP] to robotic-assisted laparoscopic prostatectomy [RALP] means a step forward or backward for the initial RALP patients. Therefore the first 105 RALPs of an experienced open prostatic surgeon and robotic novice—with tutoring in the initial 25 cases—were compared to the most recent 105 RRPs of the same surgeon. The groups were comparable with respect to patient characteristics and postoperative tumor characteristics (all ). The only disadvantage of RALP was a longer operating time; the advantages were lower estimated blood loss, fewer anastomotic leakages, earlier catheter removal, shorter hospital stay (all ), and less major complications within 90 days postoperatively ( ). Positive surgical margin rates were comparable both overall and stratified for pT stage in both groups (all ). In addition, an equivalent number of lymph nodes were removed ( ). Twelve months after surgery, patient reported continence and erectile function were comparably good (all ). Our study indicates that an experienced open prostatic surgeon and robotic novice who switches to RALP can achieve favorable surgical results despite the initial RALP learning curve. At the same time neither oncological nor functional outcomes are compromised.