Robotic-assisted laparoscopic prostatectomy is a minimally invasive procedure for removing cancerous prostate tissue.
A robotic prostatectomy is performed laparoscopically through a series of small incisions, instead of the single four- or five-inch incision needed for an open prostatectomy. The small incisions result in shorter post-operative recovery and faster return to normal activities. There is also less scarring and blood loss than in an open prostatectomy.
Precision Surgery
The system’s magnification and 3D visualization work together to enhance the surgeon’s view of the prostate, nerves, bladder and surrounding structures. It offers the surgeon the same dexterity as the human hand by “translating” the surgeon’s hand movements into the precise movements of the robot’s micro-instruments. This allows the surgeon to remove the prostate and nearby areas of concern, while sparing structures that may negatively impact urinary control and sexual function.
What to Expect
During the robotic procedure, you receive general anesthesia and are positioned on your back. The surgeon makes six small incisions in the your abdomen.
Hollow cylinders called ports are placed in the incisions, and an operating telescope, camera and surgical instruments are inserted through the ports and into the abdomen. The robot is then positioned at the operating table, and the robotic arms and camera are connected to some of the ports. The surgeon sits at a console a few feet away, controlling the robotic arms and camera. The surgeon views the surgical area through 3D goggles, which provide fine details of the body structures.
Once the prostate has been detached from surrounding structures and the urethra (urine tube) has been reattached to the bladder, the robotic arms are removed. The incision near the navel is enlarged so the entire prostate gland can be removed all at once. This is important, so that a pathologist can accurately determine the stage of the cancer. All of the instruments are removed, and a temporary urinary catheter and abdominal drain are left in place before you wake up from the anesthesia.
While all precautions are taken to reduce the likelihood of complications, no surgical treatment is completely without risk. Potential complications include infection, bleeding requiring blood transfusion, urinary incontinence, erectile dysfunction, port-site hernia and injury to adjacent organs.
You are usually released from the hospital on the same-day as surgery.
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Post-Operative Care
You are released to go home with a urinary catheter, which usually remains in place for about one week. During this time, we encourage you to walk often. You may shower, but should avoid swimming or sitting in a bathtub.
Urinary control returns after varying lengths of time. We encourage you to wear an absorbent pad initially, while you work to retrain the muscles involved in urinary control. Kegel exercises are helpful; they strengthen the muscles supporting the urethra, bladder and rectum. Heavy lifting should be avoided for about four weeks to avoid forming hernias at the incision sites.
Follow-Up Care
When you come in to have the catheter removed, we will share the pathology report concerning the stage of the cancer. We will monitor your PSA at regular intervals after surgery.
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