We have performed well over 2000 radical prostatectomies since 1983, and have evolved specialized techniques over this time that have continuously improved overall cancer control rates, and quality of life parameters like continence and sexual function. Furthermore, during this period, we have continuously decreased the length of the surgical incision through which the surgery is performed, so that now it extends just under half way from the "pubic bone" to the "belly button", decreasing the recovery time and post-surgical pain as well.

Currently, as our skill and experience with Robotic Prostatectomy has increased, we prefer to offer that minimally invasive surgical approach to patients with more limited amounts of cancer, especially those with a Gleason Score < 7, who are more likely to have organ-confined disease and who are excellent candidates for a nerve-sparing Robotic Prostatectomy. However, for the 20% or so of patients who present with larger, higher grade cancers, an open approach is often preferable because of the more extensive lymph node dissection that can be performed through an incision and because of the ability to utilize specialized techniques of handling the erectile nerves, seminal vesicles, and bladder neck that we believe leads to better outcomes for these patients.

At the Baylor Prostate Center, rather than offering the identical surgical procedure to all patients, we attempt to learn as much about each individual case prior to recommending a tailored approach based on this knowledge. Thus for many patients, an open "mini-incision!1 radical prostatectomy is recommended, while for the remaining majority, the more minimally-invasive robotic-assisted laparascopic prostatectomy is the preferable approach.

• Recently published paper documenting the lower surgical margin rates and improved outcomes with open surgery in patients operated on by Drs. Scardino and Slawin from 1983 to 2000
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