Objective The safety and feasibility of robotic-assisted radical prostatectomy (RARP) compared with retropubic radical prostatectomy(RRP) is debated. As a result it is becoming the most common approach for prostate cancer surgery in the world. We examined whether the surgical results would be improved compared to RRP at a single facility where RARP is newly performed.

Patients The subjects were 81 patients who underwent radical prostatectomy for localized prostate cancer at Juntendo University Nerima Hospital from March 2017 to December 2020.

Methods Perioperative factors analyzed in this study included the total operative time, estimated blood loss(EBL), complication and hospitalization. The recovery of urinary continence (UC) was either safety-pad only or pad-free. Oncological outcomes were assessed by surgical margin status.

Results Patients underwent RARP have the higher level of initial-PSA. But there was no significant difference on age, BMI and prostate volume between the RARP and RRP group. Perioperative EBL was less and the operative time and the length of hospital stay was shorter in the RARP group. Our study evaluating RARP and RRP reported positive surgical margins (PSM) rates. The results showed a significant difference with higher PSM rates in RRP group. Mean time to recovery of UC was no significantly difference among the two groups; 8 months in RRP group, 7 months in RARP group.

Conclusions The newly introduced RARP confirmed shorter operative time, lower EBL, shorter length of hospital stay, and fewer complications, demonstrating that RARP is less invasive than RRP.