The French Experience: The St. Augustin Transition from the Laparoscopic to the Robotic Approach

Abstract

In 1997, we performed the first standard laparoscopic radical prostatectomy with a posterior approach to the seminal vesicle at the St. Augustin Clinic. After eight years and more than 3000 patients operated on we arrived at a steady state. As a center of excellence, we personally found that it was not possible for our technique to evolve any further. This was secondary to the technical limitations on standard laparoscopy, two-dimensional (2D) vision, counterintuitive motion, and nonwristed instrumentation. The arrival of robotic technology at our institution in January 2006 began a new era in our approach to radical prostatectomy. We thought that the quality of the vision provided by the robot with a three-dimensional (3D) image and the possibility of working using six axis instruments could help us in overtaking the technical limits of laparoscopic surgery.