Transitioning from open to robotic radical prostatectomy: A look back

Abstract

It is never easy for an already experienced surgeon to take on a new procedure and sooner or later thereafter to relive their forgotten (or suppressed!) anxieties from their early experience. In this chapter, two open surgeons reflect on their transition to robotic surgery, one (TA)in the early stages of the development of the procedure and the other (LG) in the more recent times. We will focus on the learning curve as it applies to an experienced open surgeon and provide a frank and honest discussion of the challenges involved, as well as provide tips and tricks in the early and late part of the transition. Although it may be intuitive that it is “easier” for a very experienced open surgeon to transition to the technologic and surgical steps of the robotic-assisted laparoscopic prostatectomy (RARP) than to pure laparoscopy, that does not mean that it is an “easy” technique to learn. We hope that this chapter will enable the transitioning open surgeon, to learn from our experiences and ease his/her “console anxiety.” Some techniques that have been developed by us and others will be discussed for the “refinement” stages of the learning curve.