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From Summer/Fall 2013 Quest

By William J. Catalona, MD


“I do not think robotic surgery is as good or safe as open surgery for curing prostate cancer while preserving sexual and urinary function.”

Although long-term cancer cure rates with robotic surgery are not yet available, more patients need salvage radiation or hormonal therapy after having a robotic prostectomy. The side effects of continence and potency preservation are not better for patients after robotic prostatectomy, and the recovery time is essentially the same. In my opinion, it is far more difficult to get consistently good results with a robotic prostatectomy because it does not afford the surgeon as much control as with the traditional operation. Also, there is no sense of touch, and it is more difficult to suture laparoscopically. I don’t believe it allows nerve-sparing to be performed with the same degree of fine control without risking electrical thermal damage to the nerves responsible for erections and to other structures, and I do not believe removal of the cancer is as consistently complete. There are no long-term results available on the rates of cancer recurrence, metastases and deaths with robotic surgery as there are with the traditional open radical prostatectomy.

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