By now most of us know about the daVinci robot that is used for prostate surgeries 
and this new study suggests that it may not be advisable for every smaller community hospital to perform the procedure but rather rely on the high volume centers of excellence where surgeons are fully trained and familiar with the procedure. In other words every hospital is not going to have the availability of the robot, some simply due to the cost of the unit itself. BD
Use of robotic prostatectomy has mushroomed in the United States, but new data suggest it is best left in the hands of expert surgeons.
A multicenter analysis of 3,794 cases of robotic-assisted laparoscopic radical prostatectomy (RALP) performed by three experienced surgeons found that at least 1,500-1,600 cases were needed to achieve a positive surgical margin (PSM) rate of less than 10%, which is widely accepted in the surgical literature as a sign of excellence.
"We recommend that this operation should not be done by all urologists in small community hospitals, but should be focused and concentrated into those high-volume centers of excellence where the operation can be done by surgeons doing a large number of cases, very frequently, in order that they can achieve the best possible cancer-control results for their patients," lead author Dr. Prasanna Sooriakumaran said during a Feb. 15 press briefing for a symposium on genitourinary cancers.
The study will be formally presented at the symposium, which is sponsored by the American Society of Clinical Oncology, American Society for Radiation Oncology, and Society of Urologic Oncology.
Analysis: Leave Robotic Prostatectomy in the Hands of Experts : Internal Medicine News
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