Robotic enucleation

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Who is suitable for Robotic-assisted enucleation of prostate?

What are the advantages of robotic-assisted enucleation of prostate?

How is robotic-assisted enucleation of prostate performed?

What to expect after robotic-assisted enucleation of prostate?

Procedure outcomes

INTRODUCTION

Robotic-assisted enucleation of prostate is a minimally invasive (keyhole) procedure performed with precision robotic instruments for definitive treatment of enlarged prostate (BPH). As a result, the bothersome symptoms of enlarged prostate (BPH) can be eliminated or reduced significantly.
The surgeons at Melbourne Urology Centre are fully qualified and trained in minimally-invasive robotic surgery and they are highly experienced in this procedure. They offer a personalized service and can discuss your options including suitability for this treatment.

Who is suitable for Robotic-assisted enucleation of prostate?

  • Men experiencing moderate to severe symptoms of enlarged prostate (BPH):
    • Weak urinary flow
    • Incomplete bladder emptying
    • Stop and start urine flow
    • Straining to begin urination
    • A need to urinate often and in a hurry
    • Interrupted sleep because of the need to urinate
  • This procedure is most suitable for men with a very large prostate (size greater than 150cc as measured on ultrasound or MRI)
  • Men who have enlarged prostate symptoms and have failed minimally-invasive treatment options
  • Men whose prostate anatomy is not appropriate for other treatment options
    Men who have failed medical therapy, don’t want to take medication or have had side effects
  • Men who want to improve their quality of life to what it was before the onset of symptoms of enlarged prostate (BPH)

What are the advantages of robotic-assisted enucleation of prostate?

Robotic-assisted enucleation of prostate is a definitive surgical treatment for enlarged prostate (BPH) for the relief of bothersome urinary symptoms. The potential benefits include:

  • Durable improvement in urinary symptoms with low revision rates
  • Eliminates the need for lifelong use of medications
  • Achieves excellent results in patients with a very large prostate who are not suitable for other procedures

The potential benefits of robotic-assisted surgery over traditional open surgery for treatment of a very large prostate include:

  • Less blood loss
  • Smaller incisions (keyhole)
  • Shorter hospital stay
  • Faster recovery time

How is robotic-assisted enucleation of prostate performed?

  • Robotic-assisted enucleation of prostate is performed under general anaesthesia using the da Vinci System
  • The da Vinci System is a state-of-the-art robotic surgical device
  • Your surgeon is 100% in control of the robotic instruments at all times
  • This technology gives your surgeon:
    • High-definition 3D vision inside your body
    • Small instruments with greater range of movement than the human hand
    • Enhanced vision, more precise movements and control
  • Robotic-assisted enucleation of prostate replicates the traditional open surgery but uses small robotic instruments via a keyhole approach to remove the enlarged obstructing prostate tissue, creating an open prostatic urethra (channel)

What to expect after robotic-assisted enucleation of prostate?

  • Patients should expect to remain in hospital for 2 nights after the procedure
  • A urethral catheter will be required for up to a week after the procedure to allow healing to take place
  • In most cases ‘light’ activities can be resumed within a week after the procedure
  • Recovery may take up to 4-6 weeks during which time strenuous activity should be avoided
  • The most common side effects include discomfort or burning with urination, blood in the urine, urgent need to urinate and/or difficulty controlling the urge. Most of these symptoms generally subside within the first two weeks following the procedure

Procedure outcomes

  • Most patients will notice an immediate improvement in their urinary flow, pressure and bladder emptying
  • Irritable bladder symptoms including urinary frequency, urgency and nocturia (getting up at night to pass urine) tend to take longer (up to 3 months) to improve

Written by Dr. Shekib Shahbaz and Dr. Tony de Sousa

 

Thuroff, J. W., Leicht, W., Kamal, M. M., Hampel, C., (2012), Robotic-assisted laparoscopic enucleation of benign prostatic hyperplasia (BPH)110(9), [https://bjui-journals.onlinelibrary.wiley.com/doi/abs/10.1111/j.1464-410X.2012.11603.x], accessed 27/02/21.

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