Prostate Cancer Surgical Innovations: Evolution from Open to Minimally Invasive Techniques

Prostate cancer remains a significant global health concern, driving continuous advancements in surgical techniques. Minimally invasive techniques such as laparoscopic prostatectomy, laparoscopic-assisted robotic prostatectomy, and channel transurethral resection of the prostate (TURP) are associated with advantages in prostate cancer care. These include reduced blood loss, minimized postoperative pain, shorter hospital stays, and superior postoperative outcomes in terms of urinary continence and erectile function. The traditional open surgical approach has largely been replaced by the minimally invasive robot-assisted method. Thus, the historical evolution of prostate cancer surgery is examined from the pioneers to the current experts, highlighting the limitations of traditional open surgery and the subsequent advent of minimally invasive methods benefits. This chapter provides an overview of the evolving landscape of prostate cancer surgery, focusing on the emergence of minimally invasive and robotic-assisted approaches in the world versus Africa. The chapter also discusses navigated prostatectomy, lymph node dissection and the expanding applications of robotics in prostate cancer care. Enhanced precision and dexterity, real-time three-dimensional visualization, and the preservation of urinary continence and sexual function are also emphasized. Training and credentialing for robotic prostatectomy and the importance of surgeon proficiency to ensure consistent surgical quality and patient safety are discussed. Challenges relating to cost, accessibility, ethical considerations, healthcare disparities, and concerns regarding human touch and machine precision in surgery in robotic prostatectomy are explored. The future of prostatectomy with the inclusion of the impact of artificial intelligence in minimally invasive and robotic-assisted surgery on prostate cancer management will be highlighted.