Purpose: We evaluate the feasibility and efficacy of robotic assisted, lapa
roscopic pelvic lymph node dissection for locally advanced prostate cancer
staging.
Materials and Methods: Robotic assisted, laparoscopic pelvic lymph node dis
section was performed in 10 consecutive patients with mainly T3 M0 prostati
c carcinoma (robotic group). Operative, postoperative and pathological para
meters were compared with the results of the last 10 patients undergoing co
nventional, laparoscopic pelvic lymph node dissection performed with simila
r indications by the same operator (laparoscopy group).
Results: All operations were performed according to the established protoco
l with no specific intraoperative or postoperative complications. No conver
sion was required, and no technical incidents were observed in the robotic
group. Mean operating time plus or minus standard deviation for the robotic
group was 125 +/- 57 minutes (range 75 to 215), significantly longer than
that for the laparoscopy group, which was 60 +/- 15 minutes (p = 0.0013). I
n the robotic group 2 patients presented with postoperative lymphoceles rev
ealed in 1 by deep venous thrombosis and in the second by obturator pain. I
n the laparoscopy group 1 patient presented with acute urinary retention. T
he histological results concerning the number of lymph nodes removed were s
imilar in both groups (p = 0.5).
Conclusions: We show the technical feasibility of robotic assisted, laparos
copic pelvic lymph node dissection in humans. Although the benefit of this
technique has not yet been established, predictable technological improveme
nts would suggest the development of telesurgery and an improved precision
of surgical procedure.