[Does robotics improve laparoscopic radical prostatectomy in complex surgical cases?]

The radical prostatectomy is the main treatment prostate cancer in young men. However in difficult cases, another therapeutic option is often suggested.

Objective: Evaluation of the quality of the anastomosis in complex surgical cases by comparing laparoscopic radical prostatectomy (LRP) to robotic assisted radical prostatectomy (RLRP).

Material: From March 2004 to August 2009, 397 patients underwent radical prostatectomy: 176 LRP and 221 RLRP consecutively by the same surgeon. Antecedents that might have complicated dissection were analyzed: prostatic volume over 80 cc, previous inguinal hernia repair with mesh, previous pelvic surgery, body mass index over 30 and previous trans-urethral resection of prostate.

Results: In a preoperative mode, there was no significant difference between the two groups. A multivariable analysis of the quality of the anastomosis turned to the advantage of the robot (OR=2.56 [95 %CI: 1.28-5.25]), specifically for difficult cases (Odd Ratio=7.736 [95 %CI: 2.689-22.254]).

Conclusion: The use of the robot improved the quality of the anastomosis for patients that might have raised technical issues.