The first randomised controlled trial for direct comparison of open surgery for patients with localised prostate cancer found that robotic and open surgery achieved much the same results in terms of key quality of life indicators at three months.
The study, which was published in The Lancet, forms the first stage of a two year trial and reports quality of life outcomes such as urinary and sexual function. Longer-term follow-up is now required to assess the outcomes of both techniques, including on cancer survival.
Since the use of robot-assisted laparoscopic prostatectomy (RALP) reported first in 2,000, there had been rapid adoption of robotic surgery for men with prostate cancer. One million men are diagnosed with prostate cancer worldwide each year.
The line of treatment for localised disease is mostly surgical removal of the prostate gland, however, some men experience urinary and erectile problems following surgery. For most men, the operation gets rid of the cancer cells, however, for around one in three men, cancer cells might return some time after the operation.
In the US, 80-85 per cent of prostatectomies are done robotically, and although in the UK and Europe, the proportion is lower, it is increasing. Robotic surgery costs more than open surgery (the initial cost of the robot is approximately £1.5 million), to date, there had been no randomised controlled trials comparing robotic with open surgery.
The study found those whose gland was removed by a machine were doing as well after three months as those operated on by a surgeon.
They experienced less pain when doing day to day activities a week later, and reported better overall physical quality of life after six weeks, however, this leveled out over time.
Patients who underwent robot surgery also lost much less blood and spent less time in hospital, the study reveals.