Robot assisted prostate surgery may lower rates of urinary incontinence and post-surgery impotence when compared with minimally invasive laparoscopy, according to a small Italian study.
The study only comprised 120 patients who were randomized to receive a prostatectomy with either an unnamed robot assistant or with tiny tools manipulated by hand. All surgeries were performed by a single surgeon.
Researchers looked at continence rates in the men at 1, 3, 6 and 12 months following surgery and at every point continence rates were higher among the men who had received robot-assisted prostatectomy, according to the authors.
Continence rate at 3 months was 80% in the robot prostatectomy group and only 61.6% in the laparoscopic group. That gap narrowed a bit after 12 months, with 95% continence in the robot prostatectomy group and 83.3% in the laparoscopic group.
Although focused on incontinence, researchers also noted higher rates of potency among men who had received robot assisted prostatectomy, with 80% erection recovery at 12 months compared with 54.2% among the men who had received laparoscopic surgery.
Although the study was limited, especially by its size, the researchers argued that its results are valuable. Robot-assisted surgery has cornered the market on prostatectomy, especially in the U.S. where Intuitive Surgical’s (NSDQ:ISRG) da Vinci system dominates the field – but some argue that existing data doesn’t support the aggressive marketing campaigns hospitals sometimes use to promote the more expensive procedure.
"The advantages of robot-assisted radical prostatectomy (RARP) over laparoscopic radical prostatectomy (LRP) have rarely been investigated in randomized controlled trials," the authors wrote. "RARP provided better functional results in terms of the recovery of continence and potency. Further studies are needed to confirm our results."
Sunnyvale, Calif.-based Intuitive Surgical’s cross-town rival Accuray (NSDQ:ARAY) recently launched its own study comparing prostatectomy methods. Accuray plans to pit its CyberKnife non-invasive radiosurgery system against da Vinci robot-assisted surgery as well as manual laparoscopy and radiation therapy, marking the 1st time the procedures have been compared directly in a head-to-head trial.
Lowered rates of post-surgery complications may be an important boon for Intuitive Surgical, which as seen prostatectomy procedures declining in recent months amid a growing conflict about the benefits and potential downsides of aggressive prostate cancer treatment.