A recent study revealed that men with prostate cancer undergoing surgery do not fare any better with robotic surgery than with regular surgery. Although robotic surgery may lead to a shorter hospital stay, there was no difference in important outcomes such as cancer recurrence or long-term side effects like urine leakage (incontinence) and erectile dysfunction.

COMMENT: Robotic surgery has been ballyhooed as being superior to regular surgery with proponents saying there can be better visualization and less blood loss with smaller incisions. However, most of the hype is due to aggressive marketing by hospitals and and the companies who make the devices in order to pay for it: they cost about $1.5 million, not including the cost of surgeon training and annual service contracts. As a result of the cost, the procedure is much more expensive as well.

In an earlier study, men who had the robotic procedure were actually less satisfied in the long run.  In the above study, men undergoing robotic surgery were more optimistic than those undergoing traditional surgery, and thought that robotic surgery would have less side effects and they would recover faster. The only difference was getting out of the hospital 8-12 hours sooner.

Many surgeons prefer the regular surgery because they get "tactile feedback", which is important. I have seen a number of patients whose cancers were too far down to be reached by robotics and had quicker recurrence because the cancers weren't adequately visualized and thus not resected. This primarily occurs with inexperienced surgeons, so it is very important that, if you do choose robotic surgery, make sure the surgeon does at least 40-75 procedures a year.

The bottom line, however, is that it is more expensive and does not have any better outcomes. It simply increases the cost of medical care unnecessarily.