Q: How is Robotic Prostatectomy Performed?
- The surgeon sits at a console a few feet from the patient and operates the computerized controls.
- A camera and specialized instruments are mounted on the robotic arms, which are inserted through four small incisions in the patient's abdomen and connected to the robot.
- As the surgeon moves his or her hands, wrists and fingers, the robotic technology translates the motions into precise micro-movements that allow greater precision -- especially critical to spare nearby nerves that control urinary continence and sexual function.
- Following the surgery, patients are monitored overnight and usually go home the next day. A urinary catheter remains in place for about a week. Most patients return to normal activities in two to three weeks.
Q: What Are the Benefits for Patients?
Potential benefits of robot assisted prostatectomy include:
- smaller incisions and less scarring
- shorter hospital stay
- less pain
- better visualization for the surgeon
- less blood loss and transfusions
- faster recovery
- quicker return to normal activities
Q: How Do Patient Outcomes Compare for Robotic Prostatectomy?
Results of studies on robotic prostatectomy indicate that the success rate in controlling prostate cancer with robotic prostatectomy in patients with localized disease is as good as, or better than, open or laparoscopic prostatectomy. Some studies suggest that robot assisted prostatectomy may allow for earlier return of continence and potency.
Q: How safe is the surgical robot for radical prostatectomy?
Our surgical robotic system is FDA-approved for radical prostatectomies.
Q: What happens if there is a malfunction?
Recent studies show that the rate of robot malfunction is low, about 1%-4% of the time. In the unlikely event of malfunction, or if the surgeon feels that it is not safe to continue with the robot, the surgical robot will be removed and the surgery can proceed either via standard laparoscopy or via traditional open radical prostatectomy. The instruments and supplies necessary are kept on hand such that conversion, if necessary, can occur seamlessly.
Q: What are the side effects of this procedure? What can I expect?
There are several possible side-effects after prostatectomy, and many of them will depend on a patient's individual characteristics. The most common side effects are incontinence, impotence, and discomfort. A bladder catheter will be placed at the time of surgery and is generally removed one week later. Incontinence (leakage of urine) of varying degrees will be initially experienced by most patients, but should improve over time. The majority will be continent within 3-6 months.
Impotence (inability to get an erection) can also occur. Risk factors for impotence include age and pre-operative erectile dysfunction. Patients who are candidates for nerve-sparing surgery and who do recover their erections may do so within a few weeks to up to two years.
Probably the number one complaint after this surgery is pain in the perineum (the area just below the testicles), which can occur in about 10% of patients. This can last for a month or so, but usually responds well to Ibuprofen.