Harvard Health Letter

Best options for prostate surgery

Traditional versus robot-assisted procedures

A diagnosis of prostate cancer that hasn't spread comes with treatment options such as watchful waiting, hormone therapy, and radiation. But if your doctor recommends prostate removal, you have one very important decision: trust your surgery to human hands or to robotic arms controlled by your surgeon. A study led by researchers at Harvard-affiliated Massachusetts General Hospital (MGH) and published in the Journal of Clinical Oncology found little difference in the outcomes. "Yes, the two are basically the same in outcomes," says Dr. William DeWolf, professor of surgery at Harvard Medical School and urologist-in-chief at Beth Israel Deaconess Medical Center. "I don't see any difference between the two, nor should there be, based on technique."

Surgeries and outcomes

Researchers looked at the two most common methods of radical prostatectomy (removal of the prostate and nearby tissue, such as lymph nodes). During robot-assisted radical prostatectomy, the surgeon sits at a console and controls robotic arms that have long, thin, laparoscopic-type instruments. Small keyhole incisions are made across the abdomen, and the prostate is removed in its entirety. The surgery typically lasts about four hours.

In contrast, during traditional open radical prostatectomy, the surgeon holds the instruments in his or her own hands, makes a four-inch incision in the abdomen, and then removes the prostate. It lasts about two hours.

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