Advances in Techniques in Radical Prostatectomy

Since its development in 1904, radical prostatectomy (RP) has remained a fundamental surgical option in the management of localised prostate cancer. Over time, continuous advancements in surgical techniques have improved oncological outcomes while reducing functional complications. This narrative re...

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Main Authors: Hui Miin Lau, Liang G. Qu, Dixon T. S. Woon
Format: Article
Language:English
Published: MDPI AG 2025-07-01
Series:Medicina
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Online Access:https://www.mdpi.com/1648-9144/61/7/1222
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author Hui Miin Lau
Liang G. Qu
Dixon T. S. Woon
author_facet Hui Miin Lau
Liang G. Qu
Dixon T. S. Woon
author_sort Hui Miin Lau
collection DOAJ
description Since its development in 1904, radical prostatectomy (RP) has remained a fundamental surgical option in the management of localised prostate cancer. Over time, continuous advancements in surgical techniques have improved oncological outcomes while reducing functional complications. This narrative review explores the evolution of RP, depicting its progression from the traditional open approach to minimally invasive laparoscopic and robotic-assisted techniques. Key developments in RP techniques, including nerve-sparing, bladder neck-sparing and Retzius-sparing techniques as well as enhanced perioperative management, have contributed to reduced postoperative complications, namely incontinence and erectile dysfunction. Additionally, technological innovations such as augmented reality, utilising indocyanine green for improved visualisation of prostatic boundaries and illuminare-1 to easily identify nerves intraoperatively, artificial intelligence, and novel molecular imaging technologies such as PSMA PETs for improved margin assessment are shaping the future of RPs. Despite these advancements, challenges persist, including a steep learning curve associated with newer techniques, disparities in access due to cost considerations, and a lack of standardised outcome measures across different surgical approaches. This review provides insight into current trends, ongoing challenges, and future directions that may further refine surgical precision, enhance patient safety, and improve long-term treatment success in prostate cancer management.
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spelling doaj-art-da45aa631398454fb91cef26185df42b2025-08-20T03:58:31ZengMDPI AGMedicina1010-660X1648-91442025-07-01617122210.3390/medicina61071222Advances in Techniques in Radical ProstatectomyHui Miin Lau0Liang G. Qu1Dixon T. S. Woon2Department of Urology, Peninsula Health, Frankston, VIC 3199, AustraliaDepartment of Urology, Peninsula Health, Frankston, VIC 3199, AustraliaDepartment of Surgery, University of Melbourne, Melbourne, VIC 3010, AustraliaSince its development in 1904, radical prostatectomy (RP) has remained a fundamental surgical option in the management of localised prostate cancer. Over time, continuous advancements in surgical techniques have improved oncological outcomes while reducing functional complications. This narrative review explores the evolution of RP, depicting its progression from the traditional open approach to minimally invasive laparoscopic and robotic-assisted techniques. Key developments in RP techniques, including nerve-sparing, bladder neck-sparing and Retzius-sparing techniques as well as enhanced perioperative management, have contributed to reduced postoperative complications, namely incontinence and erectile dysfunction. Additionally, technological innovations such as augmented reality, utilising indocyanine green for improved visualisation of prostatic boundaries and illuminare-1 to easily identify nerves intraoperatively, artificial intelligence, and novel molecular imaging technologies such as PSMA PETs for improved margin assessment are shaping the future of RPs. Despite these advancements, challenges persist, including a steep learning curve associated with newer techniques, disparities in access due to cost considerations, and a lack of standardised outcome measures across different surgical approaches. This review provides insight into current trends, ongoing challenges, and future directions that may further refine surgical precision, enhance patient safety, and improve long-term treatment success in prostate cancer management.https://www.mdpi.com/1648-9144/61/7/1222prostate cancerradical prostatectomy
spellingShingle Hui Miin Lau
Liang G. Qu
Dixon T. S. Woon
Advances in Techniques in Radical Prostatectomy
Medicina
prostate cancer
radical prostatectomy
title Advances in Techniques in Radical Prostatectomy
title_full Advances in Techniques in Radical Prostatectomy
title_fullStr Advances in Techniques in Radical Prostatectomy
title_full_unstemmed Advances in Techniques in Radical Prostatectomy
title_short Advances in Techniques in Radical Prostatectomy
title_sort advances in techniques in radical prostatectomy
topic prostate cancer
radical prostatectomy
url https://www.mdpi.com/1648-9144/61/7/1222
work_keys_str_mv AT huimiinlau advancesintechniquesinradicalprostatectomy
AT lianggqu advancesintechniquesinradicalprostatectomy
AT dixontswoon advancesintechniquesinradicalprostatectomy