What is Prostatectomy?
Only males have a prostate, a walnut sized gland located between the penis and the bladder. The prostate is essential for reproduction, discharging semen (fluid that nourishes and protects sperm) during ejaculation, forcing it into the urethra and pushing it out of the body along with the sperm.
The prostate also plays a vital part in the efficient functioning of the urinary tract.
The most common reason for prostatectomy is to treat prostate cancer in its early stages, when restricted to a small area. In this case, the entire prostate, lymph nodes, and other surroundings tissue are removed.
Prostatectomy is also used to treat a blocked urethra caused by benign prostatic hyperplasia (BPH), a non-cancerous enlargement of the prostate gland; in this case, the entire removal is not always necessary.
The three main methods of prostatectomy are:
- Open radical, in which an incision is made in your lower abdomen to allow access to the surgical site
- Laparoscopic radical, in which special tools with a camera attached are inserted throughseveral tiny incisions in your abdomen to access the surgical site
- Robotic radical prostatectomy, the method by which three out of four prostatectomies are performed
What is Robotic Prostatectomy?
In 2000, the Federal Drug Administration approved the minimally invasive robotic da Vinci® Surgical System. The advent of a robotic alternative meant enhanced efficiency, accuracy, ease, and comfort in countless of laparoscopic procedures, including prostatectomy.
Rather than requiring large abdominal incisions to reach the surgical location to remove the prostate, robotic prostatectomy is performed through tiny ones using scaled-down instruments attached to robotic arms that are guided by the surgeon. Added benefits of heightened vision, 3-dimensional imaging and enhanced dexterity have made robotic prostatectomy the standard of care.
Although not all cases requiring prostatectomy are suitable for robotic surgery, for many men it provides the least invasive and most effective treatment; medical history, surgical scars or other irregularities that limit your options for other types of prostatectomy may make you an ideal candidate.
Approximately three out of four prostatectomies are estimated to be robotically performed. Advantages of robotic radical prostatectomy include the following:
- Significantly less pain
- Shorter recovery time
- Shorter hospital stay
- Less blood loss, meaning less chance of needing a transfusion
- Less scarring
- A faster return to normal daily activities
- In many cases, more positive clinical outcomes concerning sexual potency and continence
The most important factor in the success of robotic radical prostatectomy is the surgeon’s experience and skill in using the robotic system.
Potential complications of robotic radical prostatectomy include:
- Bleeding, rare as compared to open surgery
- Injury to nearby tissue or organs, uncommon
- A hernia, rare
- Urinary incontinence, common but often temporary with improvement over time
- Erectile dysfunction, return of function dependent on your age, previous ability to have an erection, and the condition of the nerves that control erections
Complications will depend largely on your current health, age, and the stage of your cancer; clinical studies show them as equal or less than those of other types of prostatectomy.
When Considering Robotic Radical Prostatectomy
Discuss your expectations regarding the outcome of robotic radical prostatectomy with your physician. Your current health will influence the success of the procedure and your recovery. Make sure you understand the benefits and risks for your situation.