Introduction
In the context of robotic surgery (RS), about 1.5 million robotic surgeries have been performed worldwide in the past decade or that 83% of prostatectomies were performed robotically in 2011, compared with only 17% just 6 years before (Intuitive Surgical, 2015) [1]. In the years after 2007, the number of procedures assisted by robotics almost tripled worldwide from 80,000 to more than 200,000. The number of da Vinci robotic surgical consoles grew 75% between 2007 and 2009 (from 800 to 1,400 in the USA and from 200 to 400 abroad) [1,2].
RS has been widely adopted in several specialties and in urology, it is used for reconstructive, pediatric, urogynecological and obviously oncological procedures. In 2014, the total volume of procedures in the USA was 449,000, of which 20% in urology, 52% in gynecology and 24% in general surgery. The volume of international procedures was 1121,000 in 2014, of which most procedures were in urology [1].
In this scenario, the prostate is a gland that is located in the lower part of the abdomen. It is a small organ located just below the bladder and in front of the rectum that surrounds the initial portion of the urethra [3]. In Brazil, prostate cancer is the second most common among men (behind only non-melanoma skin cancer). In absolute values and considering both sexes, it is the fourth most common type and the second most incident among men. The incidence rate is higher in developed countries compared to developing countries [3]. More than any other type, it is considered a cancer of the third age, since about three-quarters of the cases in the world occur from the age of 65 [4].
The increase observed in incidence rates in Brazil can be partially justified by the evolution of diagnostic methods, by the improvement in the quality of the country’s information systems and by the increase in life expectancy. Some of these tumors can grow quickly, spread to other organs and can lead to death. The vast majority, however, grows so slowly (about 15 years to reach 1 cm³) that it does not show signs during life or threaten the health of man [5]. According to INCA - National Cancer Institute, the estimate of new cases for the year 2016 was 61,200 cases and the number of deaths determined in the year 2013 was 13,772 deaths. The risk of a man having a prostate cancer diagnosed during his life is 16%, as it demonstrates the prevalence of this neoplasm, however, the risk of death from prostate cancer is only 3.4%, which reaffirms his indolence in a large proportion of cases [5].
Therefore, this study aimed to present, through a systematic review, the main approaches to robotic surgery as a minimally invasive procedure for the prostate.