Men's hopes for robot prostate surgery unrealistic

NEW YORK (Reuters Health) - Robot-assisted surgery for prostate cancer has been heavily hyped, and a new study suggests that men's expectations of the surgery may be too high.

Researchers found that of 171 men facing prostate cancer surgery, those having robotic surgery expected a shorter hospital stay, and a quicker return to their usual physical activity and sex life.

But those hopes may not be realistic.

Prostate removal is one treatment option for prostate cancer, and in the U.S., a majority of those surgeries are now done with the help of a "robot."

During the procedure, the surgeon sits at a console, operating robotic "arms" that extract the prostate gland through small cuts in the abdomen.

The robotic approach is expensive. And after hospitals invest the roughly $1.5 million for the machines, plus the cost of surgeon training and annual service contracts, they often aggressively market the approach -- as do the companies behind the technology.

And that may include claims that robotic surgery is better than the old-fashioned way.

"Since about the mid-2000s, people were thinking that robotic surgery was the greatest thing since sliced bread," said Dr. Judd W. Moul, a prostate surgeon at Duke University Medical Center who led the new study.

There was reason to believe that the better visualization with robotic surgery could lead to some better outcomes, Moul told Reuters Health.

On the other hand, he said, when surgeons actually use their hands, they get "tactile feedback" that's missing with the robotic approach.

And studies have suggested that while robotic surgery may have some short-term advantages -- like a somewhat shorter hospital stay -- there may be no clear difference in the most important outcomes.

So far, there's no good evidence that robotic-surgery patients fare any better as far as cancer recurrence or long-term side effects like urine leakage and erectile dysfunction.

And in an earlier study, Moul and his colleagues found that men who had the robotic procedure were actually less satisfied in the long run than those who had traditional surgery.

They guessed that patients' expectations going into surgery might have something to do with it.