Radical Prostatectomy in the Robotic Era. Comparison of Three Different Methods: Retropubic, Robotic and Perineal

Prostate cancer is the second most prevalent cancer among men and is the\ud6th cancer type leading to death. Starting with the use of PSA screening,\udthere has been a steep increase in the number of cases diagnosed with and\udtreated for localized prostate cancer. Radical prostatectomy use has increased\udfollowing the increase in the number of cases and has become the golden\udstandard for surgical procedures for their treatment. For over 50 years, while\udopen retropubic and perineal methods have been used separately, advantages\udand disadvantages of each method have been expressed in official and\udunofficial grounds. The use of nerve-sparing radical prostatectomy that\udbegan particularly after the clearer definition of the neurovascular bundles\udand the anatomy of the prostate by Walsh and the improvements in\udcontinence and potency has proved open radical retropubic prostatectomy\ud(RRP) more advantageous. The da Vinci Surgical System (Intuitive Surgical,\udSunnyvale, CA, USA), developed to qualify disadvantages of laparoscopy in\udradical prostatectomy, came into use in 2000. With Abbou’s identification of\udfirst robotic assisted radical prostatectomy (RARP), it finds increasing areas\udof application. Still there is need for further comparison of especially the\udthree methods (RPP, RRP, and RARP) in prostate cancer treatment with more\udpatients and longer follow-up periods. The objective of the first part of this\udpaper is to provide a brief comparison of RRP and RARP results and in the\udsecond part we will discuss the perineal radical prostatectom