Surgical Treatment of Prostate Cancer

Radical retropubic prostatectomy (RP) is a method of treatment of a localized prostate cancer (PC), while in the treatment of locally advanced PC, it is part of a multimodal and multidisciplinary approach. RP can be performed through an open retropubic or perineal approach or as a laparoscopic minimally invasive or robotic surgical procedure. Radical retropubic prostatectomy (RRP) is one of the most complicated urological procedures. Radical perineal prostatectomy (RPP) was the method of choice until the seventies of the last century, when the importance of pelvic lymphadenectomy was noticed. Extraperitoneal laparoscopic prostatectomy is performed when lymphadenectomy is not indicated. By performing this procedure transperitoneally, the access is wider, and an extended lymphadenectomy can be performed. Robot-assisted radical prostatectomy (RARP) was originally described at the beginning of this century. Today, this type of surgical approach is widely accepted; in America, 70–85% of all radical prostatectomies are performed this way. This procedure is determined by the challenging, long learning curve and experience of the surgeon which is crucial. With the development of hardware, software and advanced imaging technologies, this surgical technique is most often used in the treatment of prostate cancer.