Robotic Assisted Prostatectomy

What is a Robotic Assisted Prostatectomy?

This operation involves the complete removal of the prostate for cancer via keyhole surgery using the computerised daVinci robot.

Why do I need this?

  • If cancer is found in the prostate and it is decided that removal is necessary, the removal can be accomplished a number of ways. Traditionally a low abdominal incision is used as access. Since the availability of the daVinci robot the same operation can be completed using the robot.
  • The robot allows the surgeon to work with computerised instruments using a special 3D vision system.
  • The robot allows for the advantages of open surgery with the benefits of keyhole surgery.
  • Due to CO2 distension of the abdominal cavity there is reduced bleeding.

How long does it take?

  • The operation takes 2-3 hours
  • Most patients are in hospital for one night only.
  • Patients are discharged with a catheter that is left in for one week.

What are the risks?

  • The risks are the same as open total prostatectomy but due to keyhole access reduced blood loss, less pain and a quicker recovery can be expected.
  • All patients losing the prostate may have problems with incontinence and erectile dysfunction.
  • In the first month most patients notice stress incontinence that may require pad control. By 6 months over 95% have recovered.
  • Erectile Dysfunction needs to be discussed with the surgeon before the operation. The risk is increased by the need for more extensive removal if a bad cancer is being treated. Also the age of the patient and pre-existing erection problems pre-surgery affect the results.

What can I expect after surgery?

  • With a cancer contained to the prostate there is an excellent chance of cure.
  • Over 95% are happy with urine control in the longer term. One in fifty may need extra surgery to fix a leakage problem.
  • Two thirds of men with good pre-surgery erections and small cancers allowing nerve sparing are able to function sexually post-surgery with or without Viagra-type medication.
  • Post-surgery a team approach is used to maximise recovery. Doctor, nurses and physio work together to get the best result.
  • The robot approach in the USA is now used in over 80% of cases needing complete removal of the prostate.