Response to De Jager et al.’s “Analysis of the learning curve in robotic-assisted laparoscopic radical prostatectomy in a South African setting"

Abstract

Thanks for the great start in original research which was published in the first edition of African Urology. In terms of your study objective, you structured your data and analysis to clearly determine your goals. The one aspect that I would like further clarification on, is the majority of patients (41.4%) had a preoperative ISUP score of 1. I would be interested to know what the postoperative ISUP scores were, as in research by Nunez Bragayrac, et al. Gleason 6 tumours were shown to lack metastatic potential.1 Are patients who have medical aid funding subjected to the same standard of care in active surveillance when remuneration is based on operations
performed? I have no doubt that the future is in robotics for a radical prostatectomy, but it is important to realise that this is still an invasive procedure with risks, and as such, we should still maintain our discretion in recommending this as a treatment.