應用機器人腹腔鏡是一個新的前列腺摘除手術方式，我們將這個新的手術方式的經驗與傳統耻骨後前列腺摘除手術作比較。我們對總共50個手術病例作病歷檢查及病人問卷。其中29個病例為耻骨後手術方式，21個病例為機器人腹腔鏡手術方式。開刀後6個月100%的耻骨後前列腺摘除手術病人有良好的制尿能力。相對下，只有62%的機器人腹腔鏡手術病人有良好的制尿能力。制尿能力的恢復在耻骨後前列腺摘除手術病人似乎也較快。72%的病人在開刀後1個月已經有良好的制尿能力。90%的病人在開刀後3個月有良好的制尿能力。膀胱與尿道接合處的問題，機器人腹腔鏡手術方式也似乎比耻骨後手術方式稍多。這是我們應用機器人腹腔鏡手術的初步經驗。在技術更成熟之後，手術結果應該會再改進。

OBJECTIVES: A robotic prostatectomy is a new approach for prostatectomies. However, the outcomes and cost effectiveness of this approach remain uncertain. We retrospectively reviewed the outcomes and morbidity associated with a radical robotic laparoscopic prostatectomy (RRLP), in comparison to those of a radical retropubic prostatectomy (RRP) in our institution.MATERIALS AND METHODS: We retrospectively carried out medical record reviews and patient questionnaires on 50 consecutive patients who had undergone a radical prostatectomy using either RRP (n=29) or RRLP (n=21) approaches at our institution. The age of patients ranged from 48 to 69 years for the RRP group and 45 to 69 years for the RRLP group. The average follow-up times after surgery were 31 (range, 6 to 62) months for the RRP group and 9 (range, 2 to 20) months for the RRLP group. In addition to the chart review, we administered a questionnaire by mail which addressed urinary continence, potency (including the ⅡEF), and complications. A telephone questionnaire interview was conducted if a patient did not return the questionnaire. Questionnaire results were obtained for 24 of 29 patients in the RRP group and 15 of 21 patients in the RRLP group.RESULTS: The urinary continence (requiring no pads) rates at 6 months after surgery were 100% for the RRP group and 62% for the RRLP group. The time required to achieve urinary continence after surgery appeared to be shorter for the RRP group with 72% of patients continent at 1 month and 90% of patients continent at 3 months after surgery. The potency rates after bilateral nerve preservation were 69% for the RRP group (n=16) and 50% for the RRLP group (n=10). After unilateral nerve preservation, the potency rates were 43% for the RRP group (n=7) and 25% for RRLP group (n=4). The times required for patients to return to regular daily activities were 1.6 months for the RRP group 1.1 months for the RRLP group. One patient in the RRP group developed vesicourethral anastomotic stricture and required balloon dilatation and a urethrotomy. Three patients in the RRLP group experienced significant anastomotic leakage; it was resolved in 2 of them after prolonged indwelling of a Foley catheter. One patient in RRLP group required percutaneous nephrostomy for temporary urinary diversion and subsequently developed severe vesicourethral anastomotic stricture. He required suprapubic tube after endoscopic treatments for stricture failed.CONCLUSIONS: Our initial comparison indicates that a robotic laparoscopic prostatectomy appears to produce a lower continence rate and a higher complication rate than the retropubic approach in our institution. Further improvements in skill with robotic surgery may enhance future outcomes.