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Major Study: Minimally Invasive Prostate Surgery Safer Than Open Surgery

Stocks in this article: ISRG

SUNNYVALE, Calif., Sept. 16, 2013 (GLOBE NEWSWIRE) -- An independent study published online in the journal Urology found that minimally invasive surgery for prostate cancer significantly reduces complications when compared to open surgery. The study found that minimally invasive surgery for prostate cancer, including laparoscopic and robotic-assisted surgery, was associated with lower transfusion rates, shorter length of hospital stay, and lower serious postoperative complication and mortality rates compared to open prostatectomy.

In the study, the authors (Liu JJ, Maxwell BG, Panousis P, Chung BI) evaluated the National Surgical Quality Improvement Program (NSQIP) database, a national, prospective perioperative database reflecting diverse practice settings, from 2005 to 2010, for laparoscopic or robotic-assisted prostatectomy and open retropubic prostatectomy. Compared with other administrative databases that capture only inpatient events, the NSQIP database identifies complications up to 30 days postoperatively, providing more detailed characterization of complications after prostatectomy. The perioperative outcomes that were examined included surgical and total operation duration, transfusion rates, length of stay, major morbidity (cardiovascular, pulmonary, renal and infectious) and mortality.

"When evaluating minimally invasive surgery techniques, particularly robotic-assisted surgery, which is now the standard of care in the United States for prostatectomies, it is important to use the surgery it is replacing as a comparator," said Myriam Curet, MD, Chief Medical Advisor, Intuitive Surgical. "The introduction of laparoscopic urologic surgery and subsequent development of robotic techniques have dramatically increased the use of minimally invasive radical prostate surgery. This examination of the most robust, independent surgical database clearly demonstrates that a minimally invasive radical prostatectomy can be safely performed with low complication rates, particularly when compared to alternative procedures."

The study identified 5319 radical prostatectomies: 4036 minimally invasive radical prostatectomy (laparoscopic and robotic-assisted) and 1283 open. Although operating time was longer in the minimally invasive robotic-assisted prostatectomy group (270 minutes vs. 252 minutes, p-value = <.0001), there were significantly fewer perioperative blood transfusions (21% vs. 1.3%, p-value = <.0001) and shorter mean length of stay (1.8 vs. 3.2 days).

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