Robotics Involved in Most Urologic Cancer Surgeries

05.07.2018

The trend in using the robot is increasing in high volume urologic centres. Most surgeries for urologic cancers in the United States today are performed with robotic assistance.

Robotic surgeries are associated with less blood loss, fewer perioperative complications, and shorter hospital length of stay compared with open surgery, but it costs more than open surgery and takes longer to perform.

Of 105,300 prostate, bladder, and kidney cancer surgeries performed in 2005, robotics were used in 29.6% of cases. This proportion increased to 69.2% of 88,198 surgeries in 2015.

Of all patients undergoing radical prostatectomy (RP), radical cystectomy (RC), and partial nephrectomy (PN) in 2015, surgeons used robotic assistance in 85.4%, 32.8%, and 66.1% of cases, respectively. These data show that use of robotic surgery increased 4-, 11- and 110-fold for RP, RC, and PN, respectively, compared with 2005.

Contemporary outcomes of robotic-assisted RP, RC, and PN surgery are now at a minimum equal, but mostly superior, to open surgery, except for operative time and costs.

Robotic surgery now should be considered the standard in many aspects of oncologic surgery. It's become standard of care in radical prostatectomy and becoming very much the standard of care in partial nephrectomy as well. In cystectomy, there's still a lot of debate as to whether or not that's ultimately going to prove most useful.

Robotics enables surgeons to perform dissections more precisely, which gives them greater control in removing tissue and cuts down on bleeding. Robotics also can make operations less physically demanding compared with open surgery.

Reference

Gill I, Cacciamani G. The changing face of urologic oncologic surgery from 2000 - 2018 (63,141 patients)-Impact of robotics. Presented at the 2018 American Urological Association annual meeting in San Francisco, May 18-21. Abstract LBA3.

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