Robot-assisted Simple Prostatectomy

  • Giacomo NovaraEmail author
  • Alessandro Morlacco
  • Riccardo Autorino
  • Alexandre Mottrie


Simple prostatectomy (SP) is a viable option for surgical management of lower urinary tract symptoms (LUTS) in men with large prostatic adenoma. Robotic simple prostatectomy (RASP) has been popularized in the last years and combines the benefits of minimally-invasive surgery with the efficacy of conventional simple prostatectomy. In this chapter we present the different RASP techniques described in current literature (transvesical and transcapsular approach, with intra and extraperitoneal access). Moreover, we discuss the perioperative and functional outcomes of RASP, also in comparison with laparoscopic SP and Holmium laser enucleation (Holep).


LUTS BPH Prostatic adenoma Adenomectomy Simple prostatectomy Robotics RASP 


  1. 1.
    EAU Guidelines on non-neurogenic male LUTS, from
  2. 2.
  3. 3.
    Sotelo R, Clavijo R, Carmona O, Garcia A, Banda E, Miranda M, et al. Robotic simple prostatectomy. J Urol. 2008;180(4):1569–70.Google Scholar
  4. 4.
    Pokorny M, Novara G, Geurts N, Dovey Z, De Groote R, Ploumidis A, et al. Robot-assisted simple prostatectomy for treatment of lower urinary tract symptoms secondary to benign prostatic enlargement: surgical technique and outcomes in a high-volume robotic centre. Eur Urol. 2015;68(3):451–7.CrossRefPubMedGoogle Scholar
  5. 5.
    Leslie S, Abreu AL, Chopra S, Ramos P, Park D, Berger AK, et al. Transvesical robotic simple prostatectomy: initial clinical experience. Eur Urol. 2014;66(2):321–9.CrossRefPubMedGoogle Scholar
  6. 6.
    Castillo O, Vidal-Mora I, Rodriguez-Carlin A, Silva A, Schatloff O. Modified urethrovesical anastomosis during robot-assisted simple prostatectomy: technique and results. Prostate Int. 2016;4(2):61–4.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Clavijo R, Carmona O, De Andrade R, Garza R, Fernandez G, Sotelo R. Robot-assisted intrafascial simple prostatectomy: novel technique. J Endourol. 2013;27:328–32.CrossRefPubMedGoogle Scholar
  8. 8.
    Stolzenburg JU, Kallidonis P, Qazi H, Ho Thi P, Dietel A, Liatsikos EN, et al. Extraperitoneal approach for robotic-assisted simple prostatectomy. Urology. 2014;84(5):1099–105.CrossRefPubMedGoogle Scholar
  9. 9.
    John H, Bucher C, Engel N, Fischer B, Fehr JL. Preperitoneal robotic prostate adenomectomy. Urology. 2009;73:811–5.CrossRefPubMedGoogle Scholar
  10. 10.
    Sutherland DE, Perez DS, Weeks DC. Robot-assisted simple prosta- tectomy for severe benign prostatic hyperplasia. J Endourol. 2011;25:641–4.CrossRefPubMedGoogle Scholar
  11. 11.
    Pariser JJ, Pearce SM, Patel SG, Bales GT. National trends of simple prostatectomy for benign prostatic hyperplasia with an analysis of risk factors for adverse perioperative outcomes. Urology. 2015;86(4):721–5.CrossRefPubMedGoogle Scholar
  12. 12.
    Autorino R, Zargar H, Mariano MB, Sanchez-Salas R, Sotelo RJ, Chlosta PL, et al. Perioperative outcomes of robotic and laparoscopic simple prostatectomy: a European-American multi-institutional analysis. Eur Urol. 2015;68(1):86–94.CrossRefPubMedGoogle Scholar
  13. 13.
    Pavan N, Zargar H, Sanchez-Salas R, Castillo O, Celia A, Gallo G, et al. Robot-assisted versus standard laparoscopy for simple prostatectomy: multicenter comparative outcomes. Urology. 2016;91:104–10.CrossRefPubMedGoogle Scholar
  14. 14.
    Umari P, Fossati N, Gandaglia G, Pokorny M, De Groote R, Geurts N, et al. Robotic assisted simple prostatectomy (RASP) versus holmium laser enucleation of the prostate (HoLEP) for lower urinary tract symptoms in patients with large volume prostates (>100 ml): a comparative analysis from a high-volume center. J Urol. 2016;16:31214–9. pii: S0022-5347 [Epub ahead of print]CrossRefGoogle Scholar
  15. 15.
    Placer J, Gelabert-Mas A, Vallmanya F, Manresa JM, Menéndez V, Cortadellas R, et al. Holmium laser enucleation of prostate: outcome and complications of self-taught learning curve. Urology. 2009;73:1042–8.CrossRefPubMedGoogle Scholar
  16. 16.
    Shah HN, Mahajan AP, Sodha HS, Hegde S, Mohile PD, Bansal MB. Prospective evaluation of the learning curve for holmium laser enucleation of the prostate. J Urol. 2007;177:1468–74.CrossRefPubMedGoogle Scholar
  17. 17.
    Seki N, Mochida O, Kinukawa N, Sagiyama K, Naito S. Holmium laser enucleation for prostatic adenoma: analysis of learning curve over the course of 70 consecutive cases. J Urol. 2003;170:1847–50.CrossRefPubMedGoogle Scholar
  18. 18.
    Robert G, Cornu JN, Fourmarier M, Saussine C, Descazeaud A, Azzouzi AR, et al. Multicentre prospective evaluation of the learning curve of holmium laser enucleation of the prostate (HoLEP). BJU Int. 2016;117(3):495–9.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Giacomo Novara
    • 1
    Email author
  • Alessandro Morlacco
    • 1
  • Riccardo Autorino
    • 2
  • Alexandre Mottrie
    • 3
    • 4
  1. 1.Department of Surgery, Oncology, and Gastroenterology–Urology ClinicPadua University Hospital, University of PaduaPaduaItaly
  2. 2.Case Western Reserve University Hospital, Urology InstituteRichmond HeightsUSA
  3. 3.Department of UrologyOnze-Lieve-Vrouw HospitalAalstBelgium
  4. 4.ORSI AcademyMelleBelgium

Personalised recommendations