Robotic Radical Prostatectomy
What is a robotic radical prostatectomy?
A radical prostatectomy is an operation performed by a urological surgeon for prostate cancer that involves removal of the prostate gland and seminal vesicles. It can be performed using an open, robotic assisted or pure laparoscopic (keyhole) surgical approach. In robotic radical prostatectomy, which is now the preferred technique in most cases, the surgeon sits at a console and remotely controls keyhole instruments, including a camera, that have been carefully placed inside the abdominal cavity via very small incisions. The surgeon has an assistant positioned next to the patient, and his or her role is to monitor the robotic instruments that are being operated by the surgeon at the console. Using this technique, the surgeon has 10 times magnification in 3 dimensions, which allows the surgeon to perform the operation with excellent visualisation, increased ease and efficiency.
What are the advantages of robotic radical prostatectomy?
The main advantages for the patient are earlier recovery from surgery, lower blood loss and decreased incidence of bladder neck strictures. The overwhelming determinant of the success of the surgery depends on the skill of your surgeon as well as individual patient factors.
The recovery of bladder control and erectile function will depend on individual patient factors, and your surgeon will discuss these with you in detail in consultation.
What is my likely recovery from this surgery?
Most patients usually spend 2 nights in hospital. They have a catheter in their penis for 7-10 days after surgery, which is important to protect the join made during the surgery between the bladder and urethra. Most patients have only mild wound pain 72 hours after surgery and usually only require paracetamol or occasionally a codeine based medication for pain relief. Return to normal activities including work is variable depending on the type of activity. Some patients are back to office type work within 3-4 weeks. Some delay in recovery may also be due to psychological factors and these should be discussed with your surgeon.
When my catheter is removed will it be painful?
No, removing the catheter involves only minor discomfort, if at all. This is usually done in the rooms 1-2 weeks after surgery and patients are advised to bring their pads to this appointment.
What are the alternatives to surgical removal of the prostate?
The main alternatives to surgical removal are active surveillance, radiotherapy in its various forms as well as focal therapy, which is not universally accepted as a valid form of treatment.
What is active surveillance?
Active surveillance involves the monitoring of prostate cancer rather than active treatment, and takes the form of regular PSA blood tests, rectal examination, prostate MRI and repeat prostate biopsy. The time frames for the monitoring investigations will depend on individual patient factors.
Read more about the Da Vinci instrument and robotic surgery