Skip to main content

Robotic Surgery in Prostate Cancer

  • 1029 Accesses

Abstract

Prostate cancer is the second most common malignancy in men (excluding skin cancer) behind lung cancer, with more than one million cases estimated to be diagnosed worldwide in 2016. Radical prostatectomy (RP) has been the most widely used approach for the treatment of organ-confined prostate cancer. However, the high incidence of perioperative morbidities and functional derangements related with open radical retropubic prostatectomy (RRP) has led to the search for less invasive treatments to improve oncological outcomes and quality of life issues. Binder and Kramer were the first to report the feasibility of robot-assisted laparoscopic radical prostatectomy in 2001, and the Vattikuti Urology Institute at Henry Ford Hospital in Detroit, Michigan, USA, pioneered the establishment of urologic robotic surgery programs worldwide. The application of robotic technology in surgical practice has developed tremendously over the past three decades. Urologists in particular have embraced surgical robots throughout their evolution, and robot-assisted urologic surgeries have matured into everyday clinical practice in many parts of the world. Herein, we will review the available literature data about robotic surgery in prostate cancer concentrating mainly on the evolution and adaptation of robot-assisted radical prostatectomy (RARP), its perioperative/functional/oncological outcomes, results of comparative studies with open/laparoscopic RP, and relevant future directions related with optimization of RARP outcomes.

Keywords

  • Prostate cancer
  • Radical prostatectomy
  • Robot
  • Minimally invasive surgery

This is a preview of subscription content, access via your institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • DOI: 10.1007/978-3-319-56114-1_12
  • Chapter length: 25 pages
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
eBook
USD   139.00
Price excludes VAT (USA)
  • ISBN: 978-3-319-56114-1
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
Softcover Book
USD   179.99
Price excludes VAT (USA)
Hardcover Book
USD   179.99
Price excludes VAT (USA)
Fig. 12.1
Fig. 12.2
Fig. 12.3
Fig. 12.4
Fig. 12.5
Fig. 12.6
Fig. 12.7
Fig. 12.8
Fig. 12.9
Fig. 12.10
Fig. 12.11
Fig. 12.12
Fig. 12.13
Fig. 12.14

References

  1. Ferlay J, Soerjomataram I, Ervik M, et al. GLOBOCAN 2012 v1.0, Cancer incidence and mortality worldwide: IARC CancerBase No. 11. 2012. http://globocan.iarc.fr/Pages/fact_sheets_cancer.aspx. Accessed 22 July 2016.

  2. Binder J, Kramer W. Robotically-assisted laparoscopic radical prostatectomy. BJU Int. 2001;87:408–10.

    CAS  PubMed  CrossRef  Google Scholar 

  3. Jeong W, Kumar R, Menon M. Past, present and future of urological robotic surgery. Investig Clin Urol. 2016;57:75–83.

    PubMed  PubMed Central  CrossRef  Google Scholar 

  4. Young HH. VIII. Conservative perineal prostatectomy: the results of two years’ experience and report of seventy-five cases. Ann Surg. 1905;41:549–57.

    CAS  PubMed  PubMed Central  Google Scholar 

  5. Millin T. Retropubic prostatectomy; a new extravesical technique; report of 20 cases. Lancet. 1945;2:693–6.

    CAS  PubMed  CrossRef  Google Scholar 

  6. Walsh PC, Lepor H, Eggleston JC. Radical prostatectomy with preservation of sexual function: anatomical and pathological considerations. Prostate. 1983;4:473–85.

    CAS  PubMed  CrossRef  Google Scholar 

  7. Abbou CC, Hoznek A, Salomon L, Lobontiu A, Saint F, Cicco A, et al. Remote laparoscopic radical prostatectomy carried out with a robot: report of a case. Prog Urol. 2000;10:520–3.

    CAS  PubMed  Google Scholar 

  8. Abbou CC, Hoznek A, Salomon L, Olsson LE, Lobontiu A, Saint F, et al. Laparoscopic radical prostatectomy with a remote controlled robot. J Urol. 2001;165(6 Pt 1):1964–6.

    CAS  PubMed  CrossRef  Google Scholar 

  9. Pasticier G, Rietbergen JB, Guillonneau B, Fromont G, Menon M, Vallancien G. Robotically assisted laparoscopic radical prostatectomy: feasibility study in men. Eur Urol. 2001;40:70–4.

    CAS  PubMed  CrossRef  Google Scholar 

  10. Piechaud P. State of the art: urologic surgery. J Visc Surg. 2011;148(5 Suppl):e27–9. doi:10.1016/j.jviscsurg.2011.08.004. Review

    CAS  PubMed  CrossRef  Google Scholar 

  11. Patel VR, Coelho RF, Chauhan S, Orvieto MA, Palmer KJ, Rocco B, Sivaraman A, Coughlin G. Continence, potency and oncological outcomes after robotic-assisted radical prostatectomy: early trifecta results of a high-volume surgeon. BJU Int. 2010 Sep;106(5):696–702. doi:10.1111/j.1464-410X.2010.09541.x.

    PubMed  CrossRef  Google Scholar 

  12. Mottet N, Bellmunt J, Bolla M, Briers E, Cumberbatch MG, De Santis M, Fossati N, Gross T, Henry AM, Joniau S, Lam TB, Mason MD, Matveev VB, Moldovan PC, van den Bergh RC, Van den Broeck T, van der Poel HG, van der Kwast TH, Rouvière O, Schoots IG, Wiegel T, Cornford P. EAU-ESTRO-SIOG guidelines on prostate cancer. Part 1: screening, diagnosis, and local treatment with curative intent. Eur Urol. 2016; doi:10.1016/j.eururo.2016.08.003. pii:S0302–2838(16)30470–5. [Epub ahead of print] PubMed.

    Google Scholar 

  13. Hasson HM. A modified instrument and method for laparoscopy. Am J Obstet Gynecol. 1971;110(6):886–7.

    CAS  PubMed  CrossRef  Google Scholar 

  14. Partin AW, Mangold LA, Lamm DM, Walsh PC, Epstein JI, Pearson JD. Contemporary update of prostate cancer staging nomograms (Partin Tables) for the new millennium. Urology. 2001;58(6):843–8.

    CAS  PubMed  CrossRef  Google Scholar 

  15. Briganti A, Joniau S, Gontero P, et al. Identifying the best candidate for radical prostatectomy among patients with high-risk prostate cancer. Eur Urol. 2012;61:584–92.

    PubMed  CrossRef  Google Scholar 

  16. Rocco F, Carmignani L, Acquati P, Gadda F, Dell’Orto P, Rocco B, Bozzini G, Gazzano G, Morabito A. Restoration of posterior aspect of rhabdosphincter shortens continence time after radical retropubic prostatectomy. J Urol. 2006;175(6):2201–6.

    CAS  PubMed  CrossRef  Google Scholar 

  17. Van Velthoven RF, Ahlering TE, Peltier A, Skarecky DW, Clayman RV. Technique for laparoscopic running urethrovesical anastomosis:the single knot method. Urology. 2003;61(4):699–702.

    PubMed  CrossRef  Google Scholar 

  18. Novara G, Ficarra V, Rosen RC, Artibani W, Costello A, Eastham JA, Graefen M, Guazzoni G, Shariat SF, Stolzenburg JU, Van Poppel H, Zattoni F, Montorsi F, Mottrie A, Wilson TG. Systematic review and meta-analysis of perioperative outcomes and complications after robot-assisted radical prostatectomy. Eur Urol. 2012;62(3):431–52.

    PubMed  CrossRef  Google Scholar 

  19. Martin RC, Brennan MF, Jaques DP. Quality of complication reporting in the surgical literature. Ann Surg. 2002;235:803–13.

    PubMed  PubMed Central  CrossRef  Google Scholar 

  20. Tewari A, Sooriakumaran P, Bloch DA, et al. Positive surgical margin and perioperative complication rates of primary surgical treatments for prostate cancer: a systematic review and meta-analysis comparing retropubic, laparoscopic, and robotic prostatectomy. Eur Urol. 2012;62(1):1–15.

    PubMed  CrossRef  Google Scholar 

  21. Menon M, Tewari A, Baize B, Guillonneau B, Vallancien G. Prospective comparison of radical retropubic prostatectomy and robot-assisted anatomic prostatectomy: the Vattikuti Urology Institute experience. Urology. 2002;60:864–8.

    PubMed  CrossRef  Google Scholar 

  22. Tewari A, Srivasatava A, Menon M. A prospective comparison of radical retropubic and robot-assisted prostatectomy: experience in one institution. BJU Int. 2003;92:205–10.

    CAS  PubMed  CrossRef  Google Scholar 

  23. Ahlering TE, Woo D, Eichel L, Lee DI, Edwards R, Skarecky DW. Robot-assisted versus open radical prostatectomy: a comparison of one surgeon’s outcomes. Urology. 2004;63:819–22.

    PubMed  CrossRef  Google Scholar 

  24. Rocco B, Matei DV, Melegari S, Ospina JC, Mazzoleni F, Errico G, Mastropasqua M, Santoro L, Detti S, De Cobelli O. Robotic vs. open prostatectomy in a laparoscopically naïve centre: a matched-pair analysis. BJU Int. 2009;104:991–5.

    PubMed  CrossRef  Google Scholar 

  25. Krambeck AE, DiMarco DS, Rangel LJ, et al. Radical prostatectomy for prostatic adenocarcinoma: a matched comparison of open retropubic and robot-assisted techniques. BJU Int. 2009;103:448–53.

    PubMed  CrossRef  Google Scholar 

  26. Rozet F, Jaffe J, Braud G, et al. A direct comparison of robotic assisted versus pure laparoscopic radical prostatectomy: a single institution experience. J Urol. 2007;178:478–82.

    PubMed  CrossRef  Google Scholar 

  27. Drouin SJ, Vaessen C, Hupertan V, Comperat E, Misraï V, Haertig A, Bitker M-C, Chartier-Kastler E, Richard F, Rouprêt M. Comparison of mid-term carcinologic control obtained after open, laparoscopic, and robot-assisted radical prostatectomy for localized prostate cancer. World J Urol. 2009;27:599–605.

    PubMed  CrossRef  Google Scholar 

  28. Ficarra V, Novara G, Ahlering TE, et al. Systematic review and meta- analysis of studies reporting potency rates after robot-assisted radical prostatectomy. Eur Urol. 2012;62(3):418–30.

    PubMed  CrossRef  Google Scholar 

  29. Novara G, Ficarra V, D’Elia C, et al. Preoperative criteria to select patients for bilateral nerve-sparing robotic-assisted radical prostatectomy. J Sex Med. 2010;7:839–45.

    PubMed  CrossRef  Google Scholar 

  30. Ahlering TE, Rodriguez E, Skarecky DW. Overcoming obstacles: nerve-sparing issues in radical prostatectomy. J Endourol. 2008;22:745–50.

    PubMed  CrossRef  Google Scholar 

  31. Finley DS, Osann K, Chang A, Santos R, Skarecky D, Ahlering TE. Hypothermic robotic radical prostatectomy: impact on continence. J Endourol. 2009;23:1443–50.

    PubMed  CrossRef  Google Scholar 

  32. Kowalczyk KJ, Huang AC, Hevelone ND, et al. Stepwise approach for nerve sparing without countertraction during robot-assisted radical prostatectomy: technique and outcomes. Eur Urol. 2011;60:536–47.

    PubMed  CrossRef  Google Scholar 

  33. Yaxley JW, Coughlin GD, Chambers SK, Occhipinti S, Samaratunga H, Zajdlewicz L, Dunglison N, Carter R, Williams S, Payton DJ, Perry-Keene J, Lavin MF, Gardiner RA. Robot-assisted laparoscopic prostatectomy versus open radical retropubic prostatectomy: early outcomes from a randomised controlled phase 3 study. Lancet. 2016 Sep 10;388(10049):1057–66.

    PubMed  CrossRef  Google Scholar 

  34. Ficarra V, Novara G, Rosen RC, et al. Systematic review and meta- analysis of studies reporting urinary continence recovery after robot- assisted radical prostatectomy. Eur Urol. 2012;62(3):405–17.

    PubMed  CrossRef  Google Scholar 

  35. Chung JS, Kim WT, Ham WS, et al. Comparison of oncological results, functional outcomes, and complications for transperitoneal versus extraperitoneal robot-assisted radical prostatectomy: a single surgeon’s experience. J Endourol. 2011;25:787–92.

    PubMed  CrossRef  Google Scholar 

  36. Lei Y, Alemozaffar M, Williams SB, et al. Athermal division and selective suture ligation of the dorsal vein complex during robot- assisted laparoscopic radical prostatectomy: description of technique and outcomes. Eur Urol. 2011;59:235–43.

    PubMed  CrossRef  Google Scholar 

  37. Sammon J, Kim TK, Trinh QD, et al. Anastomosis during robot-assisted radical prostatectomy: randomized controlled trial comparing barbed and standard monofilament suture. Urology. 2011;78:572–9.

    PubMed  CrossRef  Google Scholar 

  38. Woo JR, Shikanov S, Zorn KC, Shalhav AL, Zagaja GP. Impact of posterior rhabdosphincter reconstruction during robot-assisted radical prostatectomy: retrospective analysis of time to continence. J Endourol. 2009;23:1995–9.

    PubMed  CrossRef  Google Scholar 

  39. Haglind E, et al. Urinary incontinence and erectile dysfunction after robotic versus open radical prostatectomy: a prospective, controlled, nonrandomised trial. Eur Urol. 2015;68:216.

    PubMed  CrossRef  Google Scholar 

  40. Di Pierro GB, Baumeister P, Stucki P, Beatrice J, Danuser H, Mattei A. A prospective trial comparing consecutive series of open retropubic and robot-assisted laparoscopic radical prostatectomy in a centre with a limited caseload. Eur Urol. 2011;59:1–6.

    PubMed  CrossRef  Google Scholar 

  41. Geraerts I, Van Poppel H, Devoogdt N, Van Cleynenbreugel B, Joniau S, Van Kampen M. Prospective evaluation of urinary incontinence, voiding symptoms and quality of life after open and robot-assisted radical prostatectomy. BJU Int. 2013;112:936–43.

    PubMed  Google Scholar 

  42. Son SJ, Lee SC, Jeong CW, Jeong SJ, Byun SS, Lee SE. Comparison of continence recovery between robot-assisted laparoscopic prostatectomy and open radical retropubic prostatectomy: a single surgeon experience. Korean J Urol. 2013;54:598–602.

    PubMed  PubMed Central  CrossRef  Google Scholar 

  43. Joseph JV, Vicente I, Madeb R, Erturk E, Patel HR. Robot-assisted versus pure laparoscopic radical prostatectomy: are there any differences? BJU Int. 2005;96:39–42.

    PubMed  CrossRef  Google Scholar 

  44. Diaz M, Peabody JO, Kapoor V, et al. Oncologic outcomes at 10 years following robotic radical prostatectomy. Eur Urol. 2014; doi:10.1016/j.eururo.2014.06.025.

    Google Scholar 

  45. Ramsay C, et al. Systematic review and economic modelling of the relative clinical benefit and cost-effectiveness of laparoscopic surgery and robotic surgery for removal of the prostate in men with localised prostate cancer. Health Technol Assess. 2012;16:1.

    CAS  PubMed  PubMed Central  CrossRef  Google Scholar 

  46. De Carlo F, Celestino F, Verri C, Masedu F, Liberati E, Di Stasi SM. Retropubic, laparoscopic, and robot-assisted radical prostatectomy: surgical, oncological, and functional outcomes: a systematic review. Urol Int. 2014;93(4):373–83.

    PubMed  CrossRef  Google Scholar 

  47. Harty NJ, Kozinn SI, Canes D, Sorcini A, Moinzadeh A. Comparison of positive surgical margin rates in high risk prostate cancer: open versus minimally invasive radical prostatectomy. Int Braz J Urol. 2013;39:639–46.

    PubMed  CrossRef  Google Scholar 

  48. Canda AE, Balbay MD. Robotic radical prostatectomy in high-risk prostate cancer: current perspectives. Asian J Androl. 2015;17(6):908–15. doi:10.4103/1008-682X.153541. discussion 913.

    PubMed  PubMed Central  CrossRef  Google Scholar 

  49. Zargar H, Lamb AD, Rocco B, Porpiglia F, Liatsikos E, Davis J, Coelho RF, Pow-Sang JM, Patel VR, Murphy DG. Salvage robotic prostatectomy for radio recurrent prostate cancer: technical challenges and outcome analysis. Minerva Urol Nefrol. 2017;69(1):26–37.

    PubMed  Google Scholar 

  50. Yuh B, Ruel N, Muldrewetal S. Complications and outcomes of robot-assisted salvage radical prostatectomy—a single institution experience. BJU Int. 2014;113(5):769–76.

    PubMed  CrossRef  Google Scholar 

  51. Salomon L, Saint F, Anastasiadis AG, Sebe P, Chopin D, Abbou CC. Combined reporting of cancer control and functional results of radical prostatectomy. Eur Urol. 2003 Dec;44(6):656–60.

    PubMed  CrossRef  Google Scholar 

  52. Pierorazio PM, Spencer BA, McCann TR, McKiernan JM, Benson MC. Preoperative risk stratification predicts likelihood of concurrent PSA-free survival, continence, and potency (the trifecta analysis) after radical retropubic prostatectomy. Urology. 2007 Oct;70(4):717–22.

    PubMed  CrossRef  Google Scholar 

  53. Shikanov SA, Zorn KC, Zagaja GP, Shalhav AL. Trifecta outcomes after robotic-assisted laparoscopic prostatectomy. Urology. 2009 Sep;74(3):619–23.

    PubMed  CrossRef  Google Scholar 

  54. Xylinas E, Durand X, Ploussard G, Campeggi A, Allory Y, Vordos D, Hoznek A, Abbou CC, de la Taille A, Salomon L. Evaluation of combined oncologic and functional outcomes after robotic-assisted laparoscopic extraperitoneal radical prostatectomy: trifecta rate of achieving continence, potency and cancer control. Urol Oncol. 2013;31(1):99–103. doi:10.1016/j.urolonc.2010.10.012.

    PubMed  CrossRef  Google Scholar 

  55. Patel VR, Sivaraman A, Coelho RF, Chauhan S, Palmer KJ, Orvieto MA, Camacho I, Coughlin G, Rocco B. Pentafecta: a new concept for reporting outcomes of robot-assisted laparoscopic radical prostatectomy. Eur Urol. 2011;59(5):702–7. doi:10.1016/j.eururo.2011.01.032.

    PubMed  CrossRef  Google Scholar 

  56. Mattei A, Fuechsel FG, Bhatta Dhar N, Warncke SH, Thalmann GN, Krause T, Studer UE. The template of the primary lymphatic landing sites of the prostate should be revisited: results of a multimodality mapping study. Eur Urol. 2008;53(1):118–25.

    PubMed  CrossRef  Google Scholar 

  57. Montorsi F, Wilson TG, Rosen RC, Ahlering TE, Artibani W, Carroll PR, Costello A, Eastham JA, Ficarra V, Guazzoni G, Menon M, Novara G, Patel VR, Stolzenburg JU, Van der Poel H, Van Poppel H, Mottrie A, Pasadena Consensus Panel. Best practices in robot-assisted radical prostatectomy: recommendations of the Pasadena consensus panel. Eur Urol. 2012;62(3):368–81.

    PubMed  CrossRef  Google Scholar 

  58. Feicke A, Baumgartner M, Talimi S, Schmid DM, Seifert HH, Müntener M, Fatzer M, Sulser T, Strebel RT. Robotic-assisted laparoscopic extended pelvic lymph node dissection for prostate cancer: surgical technique and experience with the first 99 cases. Eur Urol. 2009;55(4):876–83.

    PubMed  CrossRef  Google Scholar 

  59. Ham WS, Park SY, Rha KH, Kim WT, Choi YD. Robotic radical prostatectomy for patients with locally advanced prostate cancer is feasible: results of a single-institution study. J Laparoendosc Adv Surg Tech A. 2009 Jun;19(3):329–32.

    PubMed  CrossRef  Google Scholar 

  60. Kiyoshima K, Yokomizo A, Yoshida T, Tomita K, Yonemasu H, Nakamura M, et al. Anatomical features of periprostatic tissue and its surroundings: a histological analysis of 79 radical retropubic prostatectomy specimens. Jpn J Clin Oncol. 2004;34(8):463.

    PubMed  CrossRef  Google Scholar 

  61. Costello AJ, Brooks M, Cole OJ. Anatomical studies of the neurovascular bundle and cavernosal nerves. BJU Int. 2004;94:1071–6.

    PubMed  CrossRef  Google Scholar 

  62. Kaul S, Bhandari A, Hemal A, Savera A, Shrivastava A, Menon M. Robotic radical prostatectomy with preservation of the prostatic fascia: a feasibility study. Urology. 2005;66:1261–5.

    PubMed  CrossRef  Google Scholar 

  63. Menon M, Kaul S, Bhandari A, Shrivastava A, Tewari A, Hemal A. Potency following robotic radical prostatectomy: a questionnaire based analysis of outcomes after conventional nerve sparing and prostatic fascia sparing techniques. J Urol. 2005;174:2291–6.

    PubMed  CrossRef  Google Scholar 

  64. Ko YH, Coelho RF, Sivaraman A, Schatloff O, Chauhan S, Abdul-Muhsin HM, Carrion RJ, Palmer KJ, Cheon J, Patel VR. Retrograde versus antegrade nerve sparing during robot-assisted radical prostatectomy: which is better for achieving early functional recovery? Eur Urol. 2013;63(1):169–77.

    PubMed  CrossRef  Google Scholar 

  65. Tewari AK, Bigelow K, Rao S, Takenaka A, El-Tabi N, Te A, et al. Anatomic restoration technique of continence mechanism and preservation of puboprostatic collar: a novel modification to achieve early urinary continence in men undergoing robotic prostatectomy. Urology. 2007;69:726–31.

    PubMed  CrossRef  Google Scholar 

  66. Menon M, Muhletaler F, Campos M, Peabody JO. Assessment of early continence after reconstruction of the periprostatic tissues in patients undergoing computer assisted (robotic) prostatectomy: results of a 2 group parallel randomized controlled trial. J Urol. 2008;180:1018–23.

    PubMed  CrossRef  Google Scholar 

  67. Sammon JD, Muhletaler F, Peabody JO, Diaz-Insua M, Satya- naryana R, Menon M. Long-term functional urinary outcomes comparing single- vs double-layer urethrovesical anastomosis: two-year follow-up of a two-group parallel randomized con- trolled trial. Urology. 2010;76:1102–7.

    PubMed  CrossRef  Google Scholar 

  68. Krane LS, Bhandari M, Peabody JO, Menon M. Impact of percutaneous suprapubic tube drainage on patient discomfort after radical prostatectomy. Eur Urol. 2009;56:325–30.

    PubMed  CrossRef  Google Scholar 

  69. Sammon JD, Trinh QD, Sukumar S, Diaz M, Simone A, Kaul S, et al. Long-term follow-up of patients undergoing percutaneous suprapubic tube drainage after robot-assisted radical pros- tatectomy (RARP). BJU Int. 2012;110:580–5.

    PubMed  CrossRef  Google Scholar 

  70. Kaul S, Sammon J, Bhandari A, Peabody J, Rogers CG, Menon M. A novel method of urethrovesical anastomosis during robot-assisted radical prostatectomy using a unidirectional barbed wound closure device: feasibility study and early out- comes in 51 patients. J Endourol. 2010;24:1789–93.

    PubMed  CrossRef  Google Scholar 

  71. Jeong W, Sood A, Ghani KR, Pucheril D, Sammon JD, Gupta NS, et al. Bimanual examination of the retrieved specimen and regional hypothermia during robot-assisted radical prostatectomy: a novel technique for reducing positive surgical margin and achieving pelvic cooling. BJU Int. 2014;114:955–7.

    PubMed  CrossRef  Google Scholar 

  72. Schlomm T, Tennstedt P, Huxhold C, Steuber T, Salomon G, Michl U, Heinzer H, Hansen J, Budäus L, Steurer S, Wittmer C, Minner S, Haese A, Sauter G, Graefen M, Huland H. Neurovascular structure-adjacent frozen-section examination (NeuroSAFE) increases nerve-sparing frequency and reduces positive surgical margins in open and robot-assisted laparoscopic radical prostatectomy: experience after 11,069 consecutive patients. Eur Urol. 2012;62(2):333–40.

    PubMed  CrossRef  Google Scholar 

  73. Manny TB, Patel M, Hemal AK. Fluorescence-enhanced robotic radical prostatectomy using real-time lymphangiography and tissue marking with percutaneous injection of unconjugated indocyanine green: the initial clinical experience in 50 patients. Eur Urol. 2014 Jun;65(6):1162–8.

    PubMed  CrossRef  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ömer Acar M.D. .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and Permissions

Copyright information

© 2017 Springer International Publishing AG

About this chapter

Cite this chapter

Acar, Ö., Esen, T. (2017). Robotic Surgery in Prostate Cancer. In: Ozyigit, G., Selek, U. (eds) Principles and Practice of Urooncology. Springer, Cham. https://doi.org/10.1007/978-3-319-56114-1_12

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-56114-1_12

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-56113-4

  • Online ISBN: 978-3-319-56114-1

  • eBook Packages: MedicineMedicine (R0)