Another great advantage of laporoscopic surgery is that the patient is able to go home after two or three days and usually needs a catheter for on average only nine days. This is a shorter time than after a standard radical. After a laparoscopic patients prostatectomy are able to walk comfortably the day after surgery, within a fortnight younger men have been known to be playing golf, and soon afterwards bicycling and jogging.

Potency after laparoscopy is comparable to that experienced by men who have had the standard radical prostatectomy. The likelihood of retaining potency varies according to age and whether a nerve-sparing operation was performed. The decision to use this refinement depends on the malignancy of the tumour. If the cancer is highly malignant, then he prefers not to spare the nerves as there is a chance that the cancer cells will already have spread down the nerve sheafs.

Patients are always worried about being incontinent after surgery, and a tiny percentage of patients are for the rest of their lives. Whichever type of radical is used, incontinence of any sort affects less than ten per cent, and in only a tiny proportion of these men is it bad enough to be anything more than a slight nuisance.

Statistically there is no significant difference between continence or potency rates after the two types of radical operation, although Eden has the impression that patients have less trouble with both after keyhole surgery.

So far as can be told at this stage, there is every reason to suppose that the long-term effectiveness of radical prostatectomies is similar whether the operation is done by keyhole surgery or the open radical retropubic prostatestomy.

One disadvantage of the laparoscopic radical is that the technique demands considerable training and dexterity. It will be several years before it is available all over the country.

Benefits of keyhole

Comparison at North Hampshire Hospital of traditional radical prostatectomy with keyhole (laparoscopic) surgery

Surgery time: 148 minutes for conventional operation; 169 minutes for keyhole

Blood loss: 814 ml/ 236 ml

Blood transfusion: 0.19 units/ 0

Hospital stay: 5.3 nights/ 3 nights

Catheterisation: 13.1 days/ 8.8 days