# The Role of Robot-Assisted Radical Prostatectomy in the Management of Prostate Cancer and Future Perspectives

## TL;DR

This paper reviews robot-assisted radical prostatectomy as a leading treatment for prostate cancer, highlighting its benefits and recent advancements.

## Contribution

The paper provides a comprehensive overview of RARP's functional and oncological outcomes and discusses new robotic platforms improving accessibility.

## Key findings

- RARP offers functional benefits over open and laparoscopic procedures without compromising oncological safety.
- Techniques like nerve-sparing surgery and preservation of pelvic structures influence functional outcomes.
- New robotic platforms are making RARP more accessible in low-resource settings.

## Abstract

In this manuscript we discuss Robot-assisted radical Prostatectomy (RARP) as the treatment of choice for prostate cancer. We report how RARP has demonstrated functional benefits compared to open and laparoscopic surgical procedures, always maintaining at least an equality in terms of oncological safety. In particular we deal with some techniques that influence functional results, including nerve-sparing surgery, preservation of the lateral pelvic fascia, anterior and posterior reconstruction and preservation of the bladder neck. We highlight the advances of this procedure and the presence of some new robotic platforms that present some differences compared to the most widespread ones and which in some cases make robotic surgery more accessible even in centers with fewer resources and lower surgical volumes.

Robotic-assisted radical prostatectomy (RARP) has emerged as a leading surgical approach for localized prostate cancer in many centers worldwide. Leveraging minimally invasive techniques and advanced visualization, RARP has demonstrated benefits in perioperative and functional outcomes, and at least comparable, if not better, oncologic control relative to open radical prostatectomy (ORP) and laparoscopic radical prostatectomy (LRP). This review summarizes the current evidence on the efficacy, safety, and functional outcomes associated with RARP and discusses its role in contemporary prostate cancer management.