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May 7, 2014 — The decision about whether to have a robotic-assisted prostatectomy is not as important as your choice of surgeon, say researchers in a study published by the Journal of Clinical Oncology.

Even so, robot-assisted prostatectomies (prostate removal surgery) using the Da Vinci Surgical Robot are widely promoted as superior to open surgery and traditional laparoscopic techniques.

After analyzing data on nearly 6,000 prostatectomies, researchers found that the overall complication rate between robot-assisted surgeries and traditional open surgeries was nearly identical. Both techniques had similar complication rates, readmission rates, and rates of additional cancer therapy.

Robot-assisted procedures were associated with significantly higher rates of genitourinary and miscellaneous complications. However, there were lower rates of blood-loss, transfusions, and prolonged hospital stays. Another difference was that the cost of robot surgery was higher than non-robotic procedures, despite the shorter hospital stays and fewer blood transfusions.

In an accompanying editorial (PDF), the authors of the study concluded:

“Patients considering surgical treatment of their prostate cancer is not to choose a technique, but to choose a surgeon who is an expert at a given technique, to minimize surgical complication risk.”

Researchers concluded that robotic prostate surgery was not better or safer than traditional prostate surgery, and other studies have also linked the robotic technique with higher rates of genitourinary complications. Despite these risks and increased costs, 85% of radical prostatectomies in the United States are performed using a robot.


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