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 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.