1.1 Historical aspects Laparoscopic radical prostatectomy (LRP) has become an established treatment for organconfined prostate cancer and is increasingly performed at selected centers worldwide even though open radical retropubic prostatectomy (RRP) is widely considered the treatment of choice (Walsh, 2000). For the first time in 1992, Schuessler, a non-academic, attempted the first LRP assisted by two endourologists with laparoscopic experience in renal surgery (Schuessler et al., 1992). These pioneers were able to successfully perform 9 LRP procedures, but found no benefit over open prostatectomy. The operation was cumbersome and difficult with unacceptably prolonged operative time. The authors concluded that the procedure offered no advantage compared to RRP (Schuessler et al., 1997). In 1998 Guillonneau et al. detailed their stepwise approach to transperitoneal LRP. After substantially improving the techniques at Montsouris in France, Guillonneau and associates published their series demonstrating substantial improvements in postoperative convalescence. The operation was shown to be feasible, but more importantly, although the learning curve remained steep (Guillonneau et al., 1999). Since then, various European teams have added to the overall experience with this technique (Bollens et al., 2001; Rassweiler et al., 2001; Turk et al., 2001; De La Rosette et al., 2002). In USA, even experienced laparoscopists remained very skeptical about LRP. Gill and Zippe, who at that time focused on renal laparoscopic surgery, were one of the few who established a program of laparoscopic pelvic surgery (Gill & Zippe,2001). After 1997 LRP has slowly risen in popularity and became, in some centers, the surgical approach of choice for the treatment of the localized prostate cancer for its advantages. The lower blood loss and transfusion rate associated with the laparoscopic approach together with shorter hospital stay, reduced catheterization time, better pain control and the faster return to everyday activities seem the most encouraging improvements obtained (Hoznek et al., 2005).