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From open simple to robotic-assisted simple prostatectomy (RASP) for large benign prostate hyperplasia: the time has come

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A Letter to the Editor to this article was published on 23 March 2021

Abstract

Purpose

Robotic-assisted simple prostatectomy (RASP) has recently been studied as an alternative to open simple prostatectomy or endoscopic treatment options. At present, there is no defined recommendation for a robotic procedure as a standard surgical technique to treat large benign prostate hyperplasia.

Methods

Several robotic techniques have been described since 2007. Contemporaneously, multiple endoscopic enucleation techniques have been proposed. Nevertheless, open simple prostatectomy still remains a mainstay of therapy. We aimed to evaluate the development of robotic-assisted prostatectomy for large benign prostatic obstruction, thus comparing the technical aspects and clinical outcomes with open and endoscopic enucleation.

Results

Robotic-assisted simple prostatectomy provides significantly less blood loss and shorter hospital stay but longer operative time compared to open simple prostatectomy. Compared to endoscopic treatments, robotic approaches have a similar perioperative outcome, but cause less urethral trauma or potential bladder neck strictures. Moreover, concomitant bladder pathologies can be treated within the same setting.

Conclusion

Robotic-assisted simple prostatectomy is an effective and safe technique, and can hence be considered to become the preferred first-line therapy to treat patients with obstructive large prostate glands.

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Fig. 1

This figure is reprinted with permission from “Robotic Urology” (John H/Wiklund P, Eds), 3th edition, p 269, 2018

Fig. 2

This figure is reprinted with permission from “Robotic Urology” (John H/Wiklund P, Eds), 3th edition, p 269, 2018

Fig. 3

This figure is reprinted with permission from “Robotic Urology” (John H/Wiklund P, Eds), 3th edition, p 269, 2018

Fig. 4

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Abbreviations

RASP:

Robotic-assisted simple prostatectomy

BPH:

Benign prostate hyperplasia

OSP:

Open simple prostatectomy

LSP:

Laparoscopic simple prostatectomy

EEP:

Endoscopic enucleation of the prostate

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Authors and Affiliations

  1. Department of Urology, Kantonsspital Winterthur, 8400, Winterthur, Switzerland

    H. John & Ch. Padevit

  2. Department of Urology, St. Antonius Hospital Gronau, Gronau, Germany

    Ch. Wagner & J. H. Witt

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  1. H. John
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  2. Ch. Wagner
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  3. Ch. Padevit
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  4. J. H. Witt
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Contributions

HJ: Data collection, Data analysis, Manuscript writing. CW: Manuscript editing. CP: Manuscript editing. JW: Manuscript editing.

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Correspondence to H. John.

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John, H., Wagner, C., Padevit, C. et al. From open simple to robotic-assisted simple prostatectomy (RASP) for large benign prostate hyperplasia: the time has come. World J Urol 39, 2329–2336 (2021). https://doi.org/10.1007/s00345-020-03508-1

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  • DOI: https://doi.org/10.1007/s00345-020-03508-1

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