Prostatectomy (Robot-Assisted)

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An alternative to traditional open surgery is a less-invasive, robot-assisted prostatectomy.

If prostate cancer is discovered in the walnut-size prostate by the bladder, treatment may involve complete removal of this gland. The procedure performed to complete this process is referred to as a prostatectomy. It’s an option that tends to be recommended for men under the age of 75 who have not responded well to non-surgical procedures a urologist may recommend, such as:

  • Hormone therapy
  • Watchful waiting
  • Radiation therapy

Basics of Robot-Assisted Prostatectomy

Until recently, removal of the prostate was often done with large incisions and traditional techniques that typically meant long hospital stays and the potential for serious side effects or nerve damage. A robotic prostatectomy is a less traumatic way to deal with the shortcomings of open surgery. It’s similar to minimally invasive laparoscopic prostatectomy in that smaller incisions are also made with special instruments. The difference is that robotic technology is used to control the instruments so the surgeon can focus solely on the specifics of the procedure.

How It’s Done

During the procedure, a urologist sits in a surgical console. It’s from here they will be able to control the robotic device and view the prostate. The device itself consists of micro-surgical instruments that are manipulated to perform the precise movements needed to remove the prostate gland. It also has high-resolution cameras that produce a clear image for the surgeon on the console’s monitor. The resulting 3D visualization is sharper than images that can be viewed by the human eye alone.

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Transferring Surgeon’s Hand Movements

The surgeon’s natural hand and wrist movements are transferred to the robotic device to improve the accuracy with how incisions are made and tissues are removed. The robotic device is able to safely turn in all directions within the confined space of the pelvic area, allowing for more freedom with movements than what would normally be possible with instruments directly manipulated by hands. Even laparoscopic instruments specially designed to work in smaller spaces aren’t able to replicate a surgeon’s hand movements.

Sparing Bladder Nerves

There’s also no need to move the delicate nerves that control the bladder during prostate removal done with robotic guidance. Because these nerves, which control both bladder and sexual functions, are spared, there’s less risk of related problems with bladder nerves that sometimes become irritated or damaged.

Potential Benefits for Patients

The most noticeable benefits associated with robot-assisted prostatectomy over traditional procedures for patients include reduced operative times, less blood loss, and a lower risk of surgical wound infection. Patients may also benefit from:

  • An ability to return to normal activities sooner
  • Less pain or discomfort while recovering
  • Reduced risk of complications that sometimes include incontinence and impotence

There haven’t been many studies done on the long-term results from robot-assisted prostatectomy since it’s a fairly new technology. Yet there’s evidence suggesting it can be an effective treatment for patients who are generally healthy and not showing signs that cancer has spread. Prostate specific antigen (PSA) levels may also be checked periodically following prostate removal to look for an increase that may suggest recurrence. More than 90 percent of prostate cancers are detected when the condition is relegated to the affected area. This is also when prostate removal is most likely to be effective.

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