Laparoscopic radical prostatectomy: The new gold standard?


Radical prostatectomy is the reference treatment for localized prostate cancer. The minimal invasive approach is gaining support in a large number of centers around the world because the laparoscopic approach seems to maintain the oncological control of open surgery with added benefits for the patient. In this paper, the main aspects of the different laparoscopic approaches, their benefits, difficulties, complications, and results are described and compared with the open radical prostatectomy. A critical review of the literature on radical prostatectomy comparing the open and laparoscopic techniques and the differences between each approach was done.

This is a preview of subscription content, access via your institution.

References and Recommended Reading

  1. 1.

    Hara I, Kawabata G, Miyake H, et al.: Comparison of quality of life following laparoscopic and open prostatectomy for prostate cancer. J Urol 2003, 169:2045–2048. By comparing 106 patients after both techniques, the authors found that patients who underwent the laparoscopic technique showed a more favorable attitude toward surgery.

    PubMed  Article  Google Scholar 

  2. 2.

    Guillonneau B, Vallancien G: Laparoscopic radical prostatectomy: the Montsouris technique. J Urol 2000, 63:1643–1649.

    Google Scholar 

  3. 3.

    Seifman BD, Dunn RL, Wolf JS: Transperitoneal laparoscopy into the previously operated abdomen: effect on operative time, length of stay, and complications. J Urol 2003, 169:36–40. Reviewing 76 patients who underwent previous abdominal surgery, the authors found that laparoscopic techniques cause an increased risk of surgery and major complications that influence their hospital stay.

    PubMed  Article  Google Scholar 

  4. 4.

    Hu JC, Gold KF, Pashos CL, et al.: Role of surgeon volume in radical prostatectomy outcomes. J Clin Oncol 2003, 21:401–405. By analyzing the effect of hospital and surgeon volume of experience, it was concluded that the surgeons’ volume is inversely related to inhospital complications and length of stay.

    PubMed  Article  Google Scholar 

  5. 5.

    Cathelineau X, Cahill D, Widmer H, et al.: Transperitoneal or extraperitoneal approach for laparoscopic radical prostatectomy: a false debate over a real challenge. J Urol, 2004, 171: 714–716. Prospective study comparing 300 patients with both approaches for whom the surgeries were equivalent in terms of the immediate postoperative results.

    PubMed  Article  CAS  Google Scholar 

  6. 6.

    Hoznek A, Salomon L, Olsson LE, Antiphon P, et al.: Laparoscopic radical prostatectomy: the Creteil experience. Eur Urol 2001, 40:38–45.

    PubMed  Article  CAS  Google Scholar 

  7. 7.

    Rassweiler J, Sentker L, Seemann O, et al.: Laparoscopic radical prostatectomy with the Heilbronn technique: an analysis of the first 180 cases. J Urol 2001, 166:2101–2108.

    PubMed  Article  CAS  Google Scholar 

  8. 8.

    Bollens R, Bossche MV, Roumeguere T, et al.: Extraperitoneal laparoscopic radical prostatectomy. Eur Urol 2001, 40:65–69.

    PubMed  Article  CAS  Google Scholar 

  9. 9.

    Abreu SC, Gill IS, Kaouk JH, et al.: Laparoscopic radical prostatectomy: comparison of transperitoneal laparoscopic radical prostatectomy. Urology 2003, 61:617. The authors evaluated the advantages of this approach by describing their experience.

    Article  Google Scholar 

  10. 10.

    Bollens R, Roumeguere T, Vanden Bossche M, et al.: Comparison of laparoscopic radical prostatectomy techniques. Curr Urol Rep 2002, 3:148–151.

    PubMed  Article  Google Scholar 

  11. 11.

    Guillonneau B, Cappele O, Martinez JB, et al.: Robotic-assisted laparoscopic pelvic lymph node dissection in humans. J Urol 2001, 165:1078–1081.

    PubMed  Article  CAS  Google Scholar 

  12. 12.

    Abbou CC, Hoznek A, Salomon L, et al.: Laparoscopic radical prostatectomy with a remote controlled robot. J Urol 2001, 165:1964–1966.

    PubMed  Article  CAS  Google Scholar 

  13. 13.

    Menon M, Hemal AK, Tewari A, et al.: Nerve-sparing robotassisted radical cystoprostatectomy and urinary diversion. BJU Int 2003, 92:232–236. Prospective study of 17 patients in which the authors comment on the feasibility of this technique with minimal blood loss.

    PubMed  Article  CAS  Google Scholar 

  14. 14.

    Tewari A, Srivasatava A, Menon M: A prospective comparison of radical retropubic and robot-assisted prostatectomy: experience in one institution. BJU Int 2003, 92:205–210. By comparing 300 patients undergoing open or robot-assisted surgery, it is concluded that the robot seems safer, causing less bloodloss and shorter hospitalization with comparable oncologic and functional results.

    PubMed  Article  CAS  Google Scholar 

  15. 15.

    Pasticier G, Rietbergen JB, Guillonneau B, et al.: Robotically assisted laparoscopic radical prostatectomy: feasibility study in men. Eur Urol 2001, 40:70–74.

    PubMed  Article  CAS  Google Scholar 

  16. 16.

    Ahlering TE, Skarecky D, Lee D, Clayman RV: Successful transfer of open surgical skills to a laparoscopic environment using a robotic interface: initial experience with laparoscopic radical prostatectomy. J Urol 2003, 170:1738–1741. Prospective analysis of the learning curve of a naíve laparoscopic surgeon with the use of the robot that shows how open surgical skills are transferred to laparoscopic surgery.

    PubMed  Article  Google Scholar 

  17. 17.

    Menon M, Tewari A, Baize B, et al.: Prospective comparison of radical retropubic prostatectomy and robot-assisted anatomic prostatectomy: the Vattikuti Urology Institute experience. Urology 2002, 60:864–868.

    PubMed  Article  Google Scholar 

  18. 18.

    Salomon L, Saint F, Anastasiadis AG, et al.: Comment presenter de facon unique les resultats carcinologique et functionnels apres prostatectomie radicale. Prog Urol 2003, 13:624–628. Discussion on the difficulties encountered when describing and analyzing the results in the different articles in the literature. It also offers a possible solution by the use of a proposed format.

    PubMed  Google Scholar 

  19. 19.

    Catalona WJ, Carvalhal GF, Mager DE, Smith DS: Potency, continence, and complication rates in 1870 consecutive radical retropubic prostatectomies. J Urol 1999, 62:433–438.

    Google Scholar 

  20. 20.

    Guillonneau B, El-Fettouh H, Baumert H, et al.: Laparoscopic radical prostatectomy: oncological evaluation after 1000 cases at Montsouris Institute. J Urol 2003, 169:1261–1266. One of the largest prospective studies of the laparoscopic approach that, with a short-term follow-up, confirmed that the oncologic and biochemical results are satisfactory.

    PubMed  Article  CAS  Google Scholar 

  21. 21.

    Rassweiler J, Seeman O, Hatzinger M, Frede T: Laparoscopic anatomical radical prostatectomy: experience after 600 cases. J Urol 2003, 169:249. A good example of how the learning curve improves the surgical results in laparoscopic surgery.

    Google Scholar 

  22. 22.

    Guillonneau B, Rozet F, Cathelineau X, et al.: Perioperative complications of laparoscopic radical prostatectomy: the Montsouris 3-year experience. J Urol 2002, 167:51–56.

    PubMed  Article  Google Scholar 

  23. 23.

    Geary ES, Dendinger TE, Freiha FS, Stamey TA: Incontinence and vesical neck strictures following radical retropubic prostatectomy. Urology 1995, 45:1000–1006.

    PubMed  Article  CAS  Google Scholar 

  24. 24.

    Eastham JA, Kattan MW, Rogers E, et al.: Risk factors for urinary incontinence after radical prostatectomy. J Urol 1996, 156:1707–1713.

    PubMed  Article  CAS  Google Scholar 

  25. 25.

    Walsh PC, Marschke P, Ricker D, Burnett AL: Patient-reported urinary continence and sexual function after anatomic radical prostatectomy. Urology 2000, 55:58–61.

    PubMed  Article  CAS  Google Scholar 

  26. 26.

    Stanford JL, Feng Z, Hamilton AS, et al.: Urinary and sexual function after radical prostatectomy for clinically localized prostate cancer: the Prostate Cancer Outcomes Study. JAMA 2000, 283:354–360.

    PubMed  Article  CAS  Google Scholar 

  27. 27.

    Kim ED, Nath R, Slawin KM, et al.: Bilateral nerve grafting during radical retropubic prostatectomy: extended follow-up. Urology 2001, 58:983–987.

    PubMed  Article  CAS  Google Scholar 

Download references

Author information



Rights and permissions

Reprints and Permissions

About this article

Cite this article

Cathelineau, X., Arroyo, C., Rozet, F. et al. Laparoscopic radical prostatectomy: The new gold standard?. Curr Urol Rep 5, 108–114 (2004).

Download citation


  • Radical Prostatectomy
  • Laparoscopic Approach
  • Radical Retropubic Prostatectomy
  • Laparoscopic Radical Prostatectomy
  • Extraperitoneal Approach