Robot-assisted surgery: is it as good as original techniques?

The authors evaluated whether robot-assisted surgery, in patients with high-risk prostate cancer, compares well to other surgical technique.

One treatment option for patients with high-risk prostate cancer is surgical removal of the prostate (radical prostatectomy). Three different surgical techniques can be used for this. The oldest technique is open surgery (retropubic radical prostatectomy; removal of the prostate gland through a large incision in the abdomen). Then laparoscopic surgery was introduced (minimally-invasive technique involving very small incisions). Most recently robot-assisted surgery was developed (a minimally-invasive technique using robotic assistance to remove the prostate). Understanding possible differences in these techniques is important for achieving the best patient outcome.

In this study the authors examined whether there is a link between surgical technique and patient survival. They also examined whether there is a link between surgical technique and the risk of the cancer returning. Overall 330 patients were included in the study. 110 patients received robot-assisted surgery, 110 received open surgery and 110 received laparoscopic surgery.

There was no significant difference in the estimated 3-year survival between any of the techniques. There was a 95.4% survival rate for patients who received robot-assisted surgery, 98.1% for patients who received laparoscopic surgery and 100% for patients who received open surgery. There was no significant difference in the estimated number of patients who remained cancer free, when robot-assisted surgery (41.4%) was compared to open surgery (54.1%). Patients who received laparoscopic surgery had a higher estimated chance of remaining cancer free (77.9%). However, the authors were reluctant to conclude anything from this result due to the short follow-up time.

The authors concluded that patients who received robot-assisted surgery had similar outcomes to patients who received laparoscopic and open surgery.

The follow-up time was short for patients who received robot-assisted surgery. Further research is needed to confirm these results.