Robot-assisted simple prostatectomy versus laparoscopic simple prostatectomy: a narrative review of the literature and the state of art

Abstract

Introduction: Robot-Assisted Simple Prostatectomy (RASP) and Laparoscopic Simple Prostatectomy (LSP) are minimally invasive surgeries to treat symptoms from benign prostate hyperplasia (BPH) and results have demonstrated benefits over Open Simple Prostatectomy (OSP), but evidence has not established yet which technique is superior. We conducted a narrative review of literature with the aim of determining superiority. Methods: We searched PubMed, Embase, Web of Science and Google Scholar through April-May, 2026. The search was performed using the following terms: (Robot OR Robot-assisted OR Robotic) AND (Laparoscopy OR Laparoscopic) AND (Simple Prostatectomy OR Adenomectomy). Inclusion criteria were: (1) patients with prostate volume 80–100 mL; (2) undergoing LSP, LA, or RASP; (3) reporting data on perioperative, functional, or complication outcomes; and (4) study types including case reports (≥ 10 patients), prospective studies, retrospective studies, comparative studies, or randomized controlled trials. Results: From reviewed literature, a total of 91 articles were selected, of which 24 relate LSP/LA, 30 to the RASP, 11 to single-port RASP, 20 to comparative studies, and 4 are review articles. Conclusions: The RASP and LSP techniques are essentially equivalent in terms of perioperative and functional outcomes; however, RASP may simplify learning curve, enabling significant refinements in surgical techniques and leading into improvements regarding perioperative morbidity. Comparative studies of these techniques would be necessary to assess cost-effectiveness of both techniques

Keywords: RASP, LSP, LA, Benign prostatic hyperplasia