Results of this study are encouraging and should inspire new surgeons to go into robotics, as they suggest that after only 50 cases, robotic surgeons can expect results that are at least comparable to those of highly experienced open surgeons. Superior visualization and tremor control, together with improved instrumentation and ergonomics gives robotic technology the potential to perform surgery in a precise and delicate way, especially in places with difficult access such as the male pelvis. However, technological breakthroughs will not be translated into improved outcomes unless they are complemented with a capable surgeon and a well-integrated surgical team.
The lack of randomization is a main drawback of this study. In this context, patients who underwent RARP were younger and had fewer comorbidities than those who had open surgery, and this might have influenced the results for erectile function and continence recovery. However, patient preference is now clear, and it might be not possible to perform such randomization anymore. Results of this well-designed prospective trial suggest superiority of the robotic approach in this center with a limited caseload, and these findings are further corroborated by the results of a similar recently published prospective trial .
Robotic technology has been adopted broadly in most of the academic and private centers in the United States, and it is rapidly increasing in most western European countries. Residency and fellowship programs have largely incorporated robotics into the curriculum, and qualified mentorship and multimedia learning is more available than ever.
It has taken some time for the increased potential of robotic surgery to translate into improved patient outcomes. We believe that these encouraging results represent the beginning of a new era in robotic surgery, in which the current generation of surgeons will consistently demonstrate the superiority of the robotic approach.
Conflicts of interest
The author has nothing to disclose.
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© 2011 Published by Elsevier B.V.