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Robotic Prostatectomy

(Robotic-assisted laparoscopic prostatectomy)

Procedure overview

Radical prostatectomy is surgery to remove your prostate gland. This is the gland below the male bladder that helps produce semen. Your prostate can be removed several ways. One way is for the surgeon to make a fairly large incision (cut) into your lower abdomen to reach your prostate. This is called an open procedure.

Another kind of surgery involves making several smaller cuts and removing the prostate using a tiny camera and surgical tools. This is called a laparoscopic prostatectomy. One way for a surgeon to do laparoscopic surgery is with the help of a robot. This is known as a robotic prostatectomy.

Reasons for the procedure

Radical prostatectomy is typically used to treat prostate cancer. The robotic system can help your surgeon in several ways. The camera magnifies the area, helping the surgeon see tiny structures more easily. The robotic system can make steady, precise movements in small places where the surgeon may have trouble reaching otherwise.

Compared with an open procedure, this type of surgery may have benefits including:

  • Less bleeding

  • Faster recovery

  • Shorter hospital stay

  • Fewer problems with bowel and bladder function

Risks of the procedure

As with other surgeries that require you to be put to sleep, risks from this procedure include:

  • Reactions to medicines used during the surgery

  • Blood clots

  • Bleeding

  • Infection

  • Stroke or heart attack during the procedure

Other risks include:

  • Trouble controlling urine, called incontinence

  • Trouble getting or keeping an erection

  • Trouble controlling bowel movements

  • Injured rectum

  • Narrowing of the urethra, which is the tube in the penis that carries out urine

There may be other risks, depending on your specific medical condition. Be sure to discuss any concerns with your doctor before the procedure.

Before the procedure

Your doctor will usually give you a checkup before the surgery. This is to see that you're healthy enough for the procedure and that any diseases you may have are under control. Be sure to mention any medicines or supplements you're taking.

Your doctor may tell you to stop taking certain medicines in the days or weeks before the surgery, such as aspirin. The day before the surgery, you may need to take a laxative to empty your colon. You may be told to have only clear fluids the day before the surgery and to completely stop eating and drinking after midnight before the surgery.

During the procedure

  1. Shortly before the procedure, a health care provider will give you antibiotics and begin treatments to reduce your risk of blood clots.

  2. You will most likely lie on your back on a special table that holds your legs apart.

  3. You will receive anesthesia drugs that put you to sleep for the procedure.

  4. The surgeon will then make several small cuts into your lower abdomen.

  5. The video camera, robotic arms, and instruments will be put into your abdomen through these cuts.

  6. The surgeon will cut away your prostate and some lymph nodes around it and remove them from your body through the small cuts.

After the procedure

After the surgery, your health care team will show you how to do breathing exercises and movements while in bed to help your body recover. You may wear special stockings on your legs that reduce your risk for blood clots. After resting the first day, you may be encouraged to get up and move around more. You may be able to go home the day after the surgery.

You may have incontinence and difficulty having an erection after the surgery. Your health care team can show you how to do Kegel exercises to better control your urine.

Postsurgery instructions will probably include not driving for a week after the surgery and avoiding heavy exercise for three or four weeks. Be sure to keep any follow-up appointments so your surgeon can make sure you're recovering well.