Yusuf ŞENOĞLU, Murat KARS, Abdul Vahap BAKIR, Günal ÖZGÜR, Kamil ÇAM
Journal of Urological Surgery - 2026;13(3):227-233
Objective: Surgeons aiming to adopt minimally invasive techniques may initiate laparoscopic radical prostatectomy (LRP) either after performing a certain number of open procedures or even without prior open surgical experience. This study aimed to evaluate the feasibility, safety, and efficacy of LRP performed without previous open radical prostatectomy (ORP) experience. Materials and Methods: This retrospective analysis included the initial ORP and LRP cases performed by two surgeons who had no prior experience with either approach before completing their residency training. Demographic, perioperative, pathological, and postoperative functional outcomes at 12 months were compared between the two groups. Results: Sixty patients were analyzed (ORP: 30, LRP: 30). Baseline characteristics were similar (p>0.05). Operative time was comparable (p=0.849). Intraoperative blood loss was significantly lower in the LRP group (200 mL vs. 950 mL, p=0.001). Hospital stay was shorter for LRP (5 vs. 6 days, p=0.004). Continence rates favored LRP (100% vs. 60% continent; <0.001), whereas erectile function recovery was comparable. Minor complications occurred in 18% overall, with no major complications (Clavien ≥III). Positive surgical margin rates were 20% for ORP and 17% for LRP (p>0.99). Biochemical recurrence at 12 months (prostate-specific antigen >0.2 ng/mL) was observed in 10% of patients in both groups (p>0.99). Conclusion: LRP, even when performed by surgeons without prior ORP experience, achieved superior perioperative outcomes and better early continence recovery while maintaining early oncological control. In centers with limited access to robotic surgery due to high costs and restricted availability of trained surgeons, laparoscopy remains a safe and effective alternative for radical prostatectomy.
