Robotic and Open Prostate Surgery Show Similar Results
By HospiMedica International staff writers Posted on 09 Aug 2016 |
Image: The da Vinci Xi surgical system (Photo courtesy of Intuitive Surgical).
A new study comparing robotic and open prostatectomy shows no difference in urinary or sexual function following surgery.
Researchers at Griffith University (Gold Coast, Australia), Royal Brisbane and Women's Hospital (RBWH; Australia), and other institutions conducted a study involving 326 patients whom were randomly assigned by a computer to receive either robot-assisted laparoscopic prostatectomy or radical retropubic prostatectomy. One surgeon experienced in robotic prostatectomy performed all of the robotic-assisted procedures, and another surgeon with a history of 1,500 open prostatectomies performed all of the open procedures.
In all, 278 patients completed six weeks of follow-up, and 252 remained in follow-up for 12 weeks. The primary outcomes were urinary and sexual function assessed at 6 and 12 weeks, and again after 24 months of follow-up. The results showed no difference in urinary or sexual function; positive surgical margins and pain also did not differ between treatment groups. Robotic prostatectomy was associated with less blood loss, shorter operative duration, and a longer length of stay. The study was published on July 26, 2016, in The Lancet.
“In brief, both approaches have shown good early results, with minimally invasive benefits seen in the robot-assisted laparoscopic prostatectomy group,” concluded senior author Frank Gardiner, MD, of RBWH, and colleagues. “Urinary and sexual function are expected to continue to improve with time and, as such, significant differences in functional outcome between these surgical approaches might not become apparent until longer follow-up.”
“Trials that show equivalence for an innovation are sometimes interpreted as supporting a return to existing practice, including rediverting the training of a generation of surgeons who might have followed the innovation's evolution,” wrote Ara Darzi, MD, and Erik Mayer, MD, of Imperial College London (United Kingdom), in an accompanying editorial. "Equivalence and noninferiority should also be seen as positive, showing the innovation has preserved the intended and well established purpose of surgical intervention, such as good oncological outcomes balanced against acceptable functional side-effects.”
Radical prostatectomy uses a surgeon-controlled robot, mainly the Intuitive Surgical (Sunnyvale, CA, USA) da Vinci minimally invasive surgery system. Advantages include improved cosmetic result, less blood loss, briefer and less intense post-operative convalescence, and reduced hospitalization costs. It is also the basis of a nerve-sparing procedure called the Veil of Aphrodite, developed to minimize the erectile dysfunction common in men after undergoing traditional radical prostatectomy.
Related Links:
Griffith University
Royal Brisbane and Women's Hospital
Intuitive Surgical
Researchers at Griffith University (Gold Coast, Australia), Royal Brisbane and Women's Hospital (RBWH; Australia), and other institutions conducted a study involving 326 patients whom were randomly assigned by a computer to receive either robot-assisted laparoscopic prostatectomy or radical retropubic prostatectomy. One surgeon experienced in robotic prostatectomy performed all of the robotic-assisted procedures, and another surgeon with a history of 1,500 open prostatectomies performed all of the open procedures.
In all, 278 patients completed six weeks of follow-up, and 252 remained in follow-up for 12 weeks. The primary outcomes were urinary and sexual function assessed at 6 and 12 weeks, and again after 24 months of follow-up. The results showed no difference in urinary or sexual function; positive surgical margins and pain also did not differ between treatment groups. Robotic prostatectomy was associated with less blood loss, shorter operative duration, and a longer length of stay. The study was published on July 26, 2016, in The Lancet.
“In brief, both approaches have shown good early results, with minimally invasive benefits seen in the robot-assisted laparoscopic prostatectomy group,” concluded senior author Frank Gardiner, MD, of RBWH, and colleagues. “Urinary and sexual function are expected to continue to improve with time and, as such, significant differences in functional outcome between these surgical approaches might not become apparent until longer follow-up.”
“Trials that show equivalence for an innovation are sometimes interpreted as supporting a return to existing practice, including rediverting the training of a generation of surgeons who might have followed the innovation's evolution,” wrote Ara Darzi, MD, and Erik Mayer, MD, of Imperial College London (United Kingdom), in an accompanying editorial. "Equivalence and noninferiority should also be seen as positive, showing the innovation has preserved the intended and well established purpose of surgical intervention, such as good oncological outcomes balanced against acceptable functional side-effects.”
Radical prostatectomy uses a surgeon-controlled robot, mainly the Intuitive Surgical (Sunnyvale, CA, USA) da Vinci minimally invasive surgery system. Advantages include improved cosmetic result, less blood loss, briefer and less intense post-operative convalescence, and reduced hospitalization costs. It is also the basis of a nerve-sparing procedure called the Veil of Aphrodite, developed to minimize the erectile dysfunction common in men after undergoing traditional radical prostatectomy.
Related Links:
Griffith University
Royal Brisbane and Women's Hospital
Intuitive Surgical
Latest Surgical Techniques News
- Miniaturized Implantable Multi-Sensors Device to Monitor Vessels Health
- Tiny Robots Made Out Of Carbon Could Conduct Colonoscopy, Pelvic Exam or Blood Test
- Miniaturized Ultrasonic Scalpel Enables Faster and Safer Robotic-Assisted Surgery
- AI Assisted Reading Tool for Small Bowel Video Capsule Endoscopy Detects More Lesions
- First-Ever Contact Force Pulsed Field Ablation System to Transform Treatment of Ventricular Arrhythmias
- Caterpillar Robot with Built-In Steering System Crawls Easily Through Loops and Bends
- Tiny Wraparound Electronic Implants to Revolutionize Treatment of Spinal Cord Injuries
- Small, Implantable Cardiac Pump to Help Children Awaiting Heart Transplant
- Gastrointestinal Imaging Capsule a Game-Changer in Esophagus Surveillance and Treatment
- World’s Smallest Laser Probe for Brain Procedures Facilitates Ablation of Full Range of Targets
- Artificial Intelligence Broadens Diagnostic Abilities of Conventional Coronary Angiography
- AI-Powered Surgical Visualization Tool Supports Surgeons' Visual Recognition in Real Time
- Cutting-Edge Robotic Bronchial Endoscopic System Provides Prompt Intervention during Emergencies
- Handheld Device for Fluorescence-Guided Surgery a Game Changer for Removal of High-Grade Glioma Brain Tumors
- Porous Gel Sponge Facilitates Rapid Hemostasis and Wound Healing
- Novel Rigid Endoscope System Enables Deep Tissue Imaging During Surgery