The evolution of radical prostatectomy: a scoping review on surgical techniques and integration of surgeon-assisting concepts into the surgical workflow

BackgroundRadical prostatectomy remains a key curative treatment for localized prostate cancer which has undergone continuous transformation. Recent developments in robot-assisted and single-port surgery have followed the concept of minimizing morbidity while maintaining oncologic safety. Furthermore, the integration of artificial intelligence and novel diagnostic tools have transformed the modern surgical workflow. Therefore, the aim of this study is to give an overview of the evolution of surgical techniques, functional and oncological outcomes, and available surgeon-assisting concepts.MethodsWe conducted a non-structured review to summarize the evolution of radical prostatectomy techniques and recent developments in surgeon-assisting tools. Relevant English-language publications were identified through a targeted PubMed search using predefined keywords related to, laparoscopic, robot-assisted, Retzius-sparing, and single-port approaches. Key studies, systematic reviews, and meta-analyses were used and synthesized to provide a comparative overview. Furthermore, studies focusing on integration of artificial intelligence, novel diagnostic tools and targeted surgery are discussed.ResultsLaparoscopic surgery aims to reduce morbidity yet is technically demanding. Robotic-assisted approaches improve visualization and precision, leading to faster recovery and earlier continence recovery. Newer Retzius-sparing and single-port techniques show promising functional results, though evidence is still limited. Novel diagnostic tools including image overlay, targeted surgery, and fast and accurate intraoperative pathological assessment of resection margins are increasingly shaping modern radical prostatectomy.ConclusionRadical prostatectomy has evolved into a minimally invasive, technology-driven procedure with improved recovery and functional outcomes. Advances in robotics, imaging, and artificial intelligence enhance surgical precision. Ongoing innovation and long-term data will define the future of prostate surgery.