Prostate

About the Prostatectomy Procedure

Robot-assisted radical prostatectomy (RARP) is performed using the da Vinci® Surgical System. Instead of standing over you, the patient, the surgeon sits at a special station and sees a 3-dimensional (3-D) view of whatever the lens on the camera arm is pointed at. The lens magnifies the image to be 10 times larger than it normally looks. Using hand and foot controls, the surgeon expertly manipulates the arms of the machine from the console to perform this intricate surgery. The machine has four arms. One arm has a high-definition camera. The other arms hold the special tools that are needed for the procedure. The tools on the robotic arms are thinner, more flexible, and more precise than the surgeon’s fingers — and they never get tired!

How It Works

During the robot-assisted radical prostatectomy, your doctor may remove the lymph nodes in the region of the prostate and may have a pathologist examine them under a microscope to see if they have any cancer cells in them. If the lymph nodes are free of cancer, your doctor then removes the prostate gland, the part of the urethra that passes through it, and both seminal vesicles.  Once all of the tissue is removed, the urologist will stitch the urethra to the opening of the bladder. A Foley catheter will be inserted to drain urine after surgery and allow the area to heal. Then the incisions (port sites range from 5 – 12 mm; the largest is about ½ inch) are closed. The skin incisions are closed with sutures that dissolve on their own.

Advantages of Robot-Assisted Prostate Surgery

  • Smaller incisions heal faster and with less pain, reducing the length of hospital stay and amount of narcotic pain medication used during recovery.
  • Faster recovery of urinary control.
  • Less bleeding during surgery, which decreases the risk of needing a blood transfusion.
  • Three-dimensional viewing and 10x magnification can make surgical technique more precise compared to  standard laparoscopy.
  • Robotic surgery offers all of these benefits and yet cancer control including margin status appears similar to an operation using a 6 inch incision.