Laparoscopic radical prostatectomy is feasible. It is performed at several centers throughout the US, including my institution. It is now considered to be in its “infancy.” However, I do not believe there are any material advantages for the patient compared with open radical prostatectomy. In my opinion, it is far more difficult to get consistently good results because it does not afford the surgeon as much control as with the traditional operation. Also, it does not provide tactile feedback, and it is more difficult to suture laparoscopically. With robotic surgery, suturing is less difficult, but it still has limitations of access and lack of tactile feedback. The surgeon cannot tell how hard the robot is grasping tissue, or, if the angle of the needle is wrong and if the needle does not pass through the tissues easily, the robot continues to “muscle” its way through. With tactile feedback afforded by open surgery, the surgeon would “feel” the mistake and make the necessary adjustment. At present, information is insufficient to determine whether long-term results will be as good as with standard nerve-sparing radical prostatectomy, especially in terms of preserving sexual potency and obtaining cancer-free surgical margins. Having seen laparoscopic and robotic surgery performed by most of the world’s most experienced experts, I don’t believe it allows nerve-sparing to be performed with the same degree of fine control without risking thermal damage to the neurovascular bundles, and I do not believe removal of the cancer is as consistently complete.