Robotic Surgery for Prostate Cancer May Offer No Benefits Over Regular Surgery

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Robotic prostate surgery may be no more beneficial than a conventional operation, a randomized trial has found.

In robotic surgery, the doctor operates through quarter-inch incisions using tiny instruments and cameras guided by robot, giving the surgeon a clear view of the operating site and precise control of the tools. In conventional surgery, the doctor makes a larger incision and uses standard surgical equipment.

Several earlier observational studies had reached the same conclusion. For the current study, in The Lancet, researchers randomly assigned 163 men with localized prostate cancer to robotic surgery and 163 to conventional operations.

Three months after the operations, there was no difference between the two groups in urinary or sexual function, or in complications of surgery. The operations were equally effective in removing cancerous tissue.

Longer-term follow up is needed, but for now, “we recommend that patients choose a urologist with whom they have rapport and who is experienced with either open or robotic prostatectomy,” said the senior author, Dr. Robert A. Gardiner, a urologist at the Royal Brisbane and Women’s Hospital in Australia. “At this stage, we advise that the choice should be based on the person and not on the operative approach. A surgeon may have good clinical reasons for advocating one or the other approach, and the patient should be open to consider his or her advice.”