Prostate cancer has the first incidence rate and the second mortality rate among male tumor patients in Europe and the United States. Before the 1980s, the incidence of prostate cancer in China was very low, less than 1 per 100,000, but now the incidence of prostate cancer has exceeded 5 per 100,000. This is related to the change in diet and lifestyle of the nation, the increase in life expectancy and the increasing level of early screening for prostate cancer diagnosis. To date, radical prostatectomy is still the most effective treatment for limited prostate cancer, and the technique of radical prostatectomy has evolved from traditional open surgery to today’s minimally invasive surgery. The technique of radical retropubic prostatectomy (RRP) is the traditional open radical prostatectomy, which was pioneered by Dr. Millin in Ireland in the 1940s for the treatment of benign prostatic hyperplasia, and adopted by Dr. Chute in the 1950s for the treatment of prostate cancer. The surgeons were troubled by the high incidence of postoperative complications such as urinary incontinence and impotence. In 1979, after an in-depth study of the local anatomy of the prostate and its surrounding tissues, physicians Reiner and Walsh [4] described the anatomical relationship between the prostate and the connecting vascular and nerve tracts and proposed an anatomical approach to the prostate via the posterior pubic bone, which allows for optimal exposure of the operative field, increased operative space and reduced intraoperative bleeding; preservation of the normal vascular and nerve tracts and reconstruction of the bladder neck. Reiner et al.’s theory has been successfully applied and repeatedly verified in clinical practice, making a breakthrough in RRP, which is a milestone in radical prostate cancer surgery. In 1997, Schuessler first reported LRP. Schuessler thought that LRP was difficult to perform and had no advantage over conventional RRP. In 2000, Guillonneau, Vallancien [6] and Abbou reported the experience of LRP application and improvement methods. Our scholars completed the first case of LRP in 2000, and short-term follow-up reports of LRP in a single center in China showed that: the average time of LRP surgery from 2000 to 2005 was 240 min, the average bleeding volume was 100 ml, the average postoperative extubation time was 13 d, the positive margin rate was 24.1% and correlated with pathological staging; there was no biochemical recurrence at 5 years 79.4%, including pT2 28.4% , pT3a 62.1%, and pT3b 79.9%, similar to that reported by the Montsouris Center in France. It is suggested that compared with RRP, LRP has the advantages of less trauma, less bleeding, clear visualization which helps to protect the neurovascular bundle and preserve the external urethral sphincter, thus reducing the incidence of postoperative urinary incontinence as well as impotence. Robot-assisted laparoscopic radical prostatectomy (RALRP) In 2000, 2 French medical centers reported the induceability of RALRP one after another. These two medical centers have been performing LRP for many years and have extensive clinical experience. Initial experience with da Vinci robot-assisted LRP was reported by American physicians Menon and Tewari et al. Nowadays, da Vinci robot-assisted LRP has been used more and more widely in clinical practice. Several research centers in Europe and the United States have done in-depth studies in this area and have compared RALRP with RRP and LRP with regard to the following aspects. 3.1 Intraoperative data: the average operative time for LRP was 151-288 min, while the average operative time for RALRP was 141-342 min. the transfusion rate for RRP was 9%, while the transfusion rate for RALRP was 0-5%; 3.2 Positive margin rate: mainly related to the pathological level of the tumor, the positive margin rate for T2 patients was 19%-29% for RPR; 10%-23% for LRP 3.3 Functional recovery: The functional recovery of urinalysis after RRP, LRP and RALRP was 92% to 98%, and 70% of patients could recover sexual function, and there was no statistically significant difference in functional recovery among the three modalities; 3.4 Learning curve: Menon had done a study that a physician with LRP technique experienced 18 RALRPs. After a physician experienced 18 RALRPs, his operative time for RALRP was comparable to the average operative time for LRP, i.e., his proficiency in operating RALRP was now similar to that of LRP. With the development of robotic laparoscopic technology, traditional radical prostatectomy is worthy of both traditional open radical prostate cancer surgery and traditional laparoscopic radical prostate cancer surgery. the place of RALRP in radical prostate cancer surgery will become increasingly important. RALRP accounts for half of all radical prostate cancer procedures in the United States, and an increasing number of urologists are happy to learn the RALRP technique. In addition to tumor grading, the operating experience of the urologist is closely related to postoperative quality of life. The Department of Urology of East China Hospital, Fudan University has been performing RALRP with the latest da Vinci and surgical robotic system with good results. At the 2009 European Annual Meeting of Urology (EAU), Dr. sotelo from Venezuela applied the da Vinci robot to mimic open retrograde radical prostate cancer surgery, which reduced the incidence of rectal injury. Dr. Annino, Italy, reported experience with the application of a tension-free, energy-free technique to perform separation of the vascular nerve bundle, i.e., separating the cystoprostatic junction before separating the seminal vesicle and bladder, thus avoiding nerve injury at this level. In the era of minimally invasive surgery, based on the pursuit of scarless abdominal wall surgery, the NOTES technique was proposed in 2004, i.e. Natural Orifice Translumenal Endoscopic Surgery (NOTES) using the body’s natural cavity, which has been successively applied in general surgery, gynecology and Urology. At the 2010 EAU in Barcelona, a video of a Laparo-endoscopic Single Site Surgery (LESS) for radical prostate cancer using the latest surgical instruments was presented. It can be said that radical prostate cancer treatment has entered the minimally invasive era, and RALRP will take the main position, while NOTES and LESS will be rapidly promoted and used.