Prostate cancer is the growth of abnormal cells in the prostate. Robotic prostatectomy is a relatively new, minimally invasive treatment option for men with localized prostate cancer (cancer that has not spread). In this procedure, all or part of the prostate and some of the tissue around it is removed, thus eliminating the cancer. Robotic prostatectomy is performed through several tiny incisions (3 to 5 millimeters in diameter) through which tubes are inserted.
WHEN IS IT INDICATED?
Robotic prostatectomy is indicated in patients who:
- Have localized prostate cancer and prefer not to undergo open surgery; and
- Are otherwise in good health.
PRE-PROCEDURE GUIDELINES
Patients should write a list of all prescription and over-the-counter medications they take, including herbs, supplements, and vitamins, and bring it to the surgeon. The surgeon may ask that patients refrain from eating or drinking after midnight on the night before their procedure, or to stop taking certain medications.
WHO IS ELIGIBLE?
Patients with localized prostate cancer who have discussed treatment options with their physician are eligible. Typically, candidates have a life expectancy of at least 10 years and are fit enough to withstand anesthesia.
WHAT TO EXPECT
The patient will lie down on the operating table with his head facing up. An intravenous (IV) line will be inserted into the patient’s arm or wrist, into which anesthetics and other medications can be administered. The surgeon will make several tiny incisions in the abdominal wall and insert tubes through which he or she passes miniature surgical instruments and a camera to the area near the prostate. The surgical system consists of a 3- or 4-armed robot that is connected to the patient and a remote console, at which the surgeon sits. The surgeon’s view is greatly magnified due to a high-resolution 3-dimensional image of the surgical area of interest (prostate and surrounding space). The surgeon moves robotic arms and foot pedals, which translate into real-time movements of the instrument tips.
Using the robotic arms, the surgeon will first detach the patient’s prostate from the bladder. Then he or she will remove the prostate and any surrounding tissue or lymph nodes that are affected.
Once the prostate and any surrounding tissue or lymph nodes are removed, the surgeon will reattach the bladder to the urethra and insert a catheter to facilitate urine drainage during healing.
POST-PROCEDURE GUIDELINES
After robotic prostatectomy, the patient will be brought to a recovery room and his vital signs will be monitored. Most patients are discharged 1 to 2 days after the procedure. At home, patients should follow the physician’s instructions.
POTENTIAL COMPLICATIONS
Complications from robotic prostatectomy may include:
- Urinary incontinence;
- Erectile dysfunction;
- Pain;
- Blood loss;
- Rectal injury;
- Non control of the malignancy; and
- Infections.
