LAUSR

Since the introduction of surgical robots for performing radical prostatectomy (RP), urologists have argued the merits of open versus robotic surgery. Often, attitudes are influenced by individual bias, which is frequently driven by a surgeon's experience. However, high-quality data ultimately drive policies and practice. In this issue of European Urology, Thompson et al [1] present a retrospective review of a large experience of both open and robotic RP and nicely correlate results with a “learning curve” based on the number of surgical procedures. Single-surgeon experience theoretically removes the surgeon factor from the equation. Indeed, we published a report earlier in our experience making that very argument [2]. Nonetheless, a surgeon may have particular skills or abilities with open surgery that might not translate fully to robotic/laparoscopic surgery, and vice versa. In addition, there are significant questions about the generalizability of single-surgeon experience to other surgeons in other hospitals or even on other continents. Despite reservations about the value of single-surgeon experience, it is difficult not to reflect on personal experience. The senior author of this editorial has performed several thousand retropubic RPs (RRPs) and more than 7000 robotic-assisted laparoscopic RPs (RALPs). Currently, almost 99% of RPs are performed robotically. Nonetheless, we are still not convinced that functional outcomes are better with RALP. We remain disappointed that a small but definite proportion of patients have significant incontinence and the number is not much different from the open experience. Results we obtain with nerve-sparing surgery for preservation of erectile function with RALP seem at least comparable to most reports, but no