Stratification of Operative Time in Robotic-Assisted

Prostate cancer (PC) is the most prevalent tumor among men and the fifth in number of deaths worldwide. The incidence is approximately 1.28 million cases
every year [1]. Brazil related 15576 deaths in 2018 and estimates 65840 new cases in 2020.

PC has a multifactorial etiology which family history, especially in first-degree relatives, is associated with an increased risk of the disease. Age, obesity, and the afrodescendent ethnicity are some other risk factors described.

Therapeutic options of localized PC includes external radiotherapy, brachytherapy and radical prostatectomy, none of which showed superiority over the others in terms of overall survival. The last one is considered the gold standard for localized or locally advanced disease in patients with life expectancy of more than 10 years.

Surgical treatment can be performed by three different techniques: Open radical prostatectomy (ORP), laparoscopic radical prostatectomy (LRP) or robot-assisted laparoscopic prostatectomy (RALP). A recent systematic review found no statistically significant difference between oncological and functional outcomes (urinary continence and sexual potency). In terms of hospitalization time and need for hemotransfusion, minimally invasive techniques showed better results.

The RALP shows promise as a technique presenting satisfactory functional and oncological results. Current literature has suggested that basic proficiency in robot-assisted laparoscopic surgery can be achieved with a relatively few number of cases, less than the learning curve of laparoscopic radical prostectomy, whose basic skill is achieved from 25 to 40 cases. However, the amount of cases needed to achieve mastery in RALP is unclear [9]. Three-dimensional (3D) vision, better ergonomics, image amplification, greater amplitude and degree of movement in the clamps are some of the additional benefits of robotic technology.

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