The da Vinci robotic system is a specialized surgical system that offers both surgeons and patients a number of potential benefits over conventional surgery. When it comes to robotic surgery prostate conditions can be treated using this approach. At Melbourne Urology Centre, our specialist urologists are vastly experienced in performing procedures using the da Vinci system.
The da Vinci robotic system is a minimally-invasive surgical approach. Some of the benefits of robotic surgery for prostate conditions for eligible patients may include:
- Less blood loss
- Smaller incisions
- A shorter hospital stay
- Faster recovery time.
Some of the benefits of robotic surgery for prostate conditions for the surgeon include:
- High definition 3D vision inside the patient’s body
- Small instruments that allow for a greater range of movements than the human hand can perform
- Overall improved dexterity and vision that allows the surgeon to make precise movements with enhanced control.
There are two robotic-assisted surgical procedures that are performed to treat prostate conditions: robotic-assisted radical prostatectomy and robotic-assisted enucleation of the prostate.
Robotic Surgery Prostate: Robotic-Assisted Radical Prostatectomy
Robotic-assisted radical prostatectomy is a type of prostate robotic surgery procedure whereby the prostate gland and some of the surrounding tissue are removed. It is a minimally-invasive procedure that is used to treat prostate cancer; this procedure aims to remove all of the cancer.
Robotic surgery prostate – radical prostatectomy is a curative surgical option for men with prostate cancer that have a life expectancy of more than 8-10 years. This surgical approach may be considered for men who:
- Have cancer that is confined to the prostate
- Have cancer that is considered clinically significant and likely to cause morbidity and/or mortality in their lifetime
- Are otherwise in generally good health
- Will feel more comfortable with the knowledge that the cancerous prostate has been physically removed from their body (as compared to other treatments).
During this robotic surgery for the prostate, the patient is placed under general anaesthesia. Several small incisions are made in the abdomen, and the surgical instruments and camera are inserted through these. The surgeon controls the robotic tools to remove the prostate and seminal vesicles. In some instances where the cancer is considered high-risk, some of the surrounding lymph tissue may also be removed. This provides the surgeon with information as to whether or not the cancer has spread beyond the prostate. The urethra is then carefully reattached to the bladder (anastomosis). The instruments are removed and the incisions are carefully closed.
Patients generally remain in hospital for 2-3 nights following this procedure but will be up and walking around the following day. A urinary catheter needs to remain in place for 10-14 days in order to the allow for healing of the anastomosis. There is usually some mild pain or discomfort, which can be managed with medication.
For men with no evidence of cancer spread beyond the prostate, this procedure provides a curative long term prognosis. This procedure does carry the risk of long term erectile dysfunction, which may occur because the nerves for erection run alongside the prostate. For patients whose erectile function does not fully recover, there are a number of definitive management options available.
Robotic Surgery Prostate: Robotic-Assisted Enucleation of the Prostate
Robotic-assisted enucleation of the prostate is a type of robotic surgery for prostate enlargement. During this procedure, non-cancerous (benign, BPH) enlarged prostate tissue is removed using the specialized robotic equipment. This minimally invasive procedure is an excellent surgical treatment option for patients with a very large prostate.
Robotic surgery prostate- enucleation of the prostate may be a suitable treatment option for men who:
- Are experiencing the bothersome urinary symptoms of benign prostatic hyperplasia (BPH) such as:
- Weak stream of urine
- Incomplete emptying of the bladder
- Stop and start when urinating
- Straining to begin urination
- Increased urgency or frequency of urination
- Interrupted sleep because of the need to urinate (nocturia)
- Other complications of enlarged prostate
- Are seeking an alternative treatment to TURP for their BPH
- Have BPH symptoms and have failed other minimally-invasive treatments
- Have prostate anatomy that is inappropriate for other treatment options
- Have failed medical therapy, do not want to take medications, or experience side effects with medication
- Want to improve their quality of life to what it was prior to the onset of their BPH symptoms.
During this robotic surgery for prostate enucleation, the patient is placed under general anaesthesia. A number of small incisions are made in the abdomen, and the surgical instruments and camera are inserted through these. The surgeon controls the robotic tools to remove only the enlarged part of the prostate that is causing the symptoms of obstruction. The enlarged lobes are “shelled out” (enucleated) and then removed through a small incision in the bladder, creating an open prostatic urethra to allow good urine flow. The bladder is carefully repaired using absorbable sutures. The instruments are removed and the incisions are closed with a specialized technique that minimizes the chance of scarring.
Patients should expect to remain in hospital for 2-3 nights following this procedure. A urinary catheter is inserted and needs to remain in place for around 5-7 days in order to allow the bladder to heal.
This procedure should not be confused with the ‘radical prostatectomy’ described above. During the robotic enucleation of the prostate, the prostate capsule, surrounding nerves and urinary sphincter are not disrupted. This significantly reduces the chances of erection problems and urinary incontinence. Most patients will notice an immediate improvement in their urinary flow, pressure and bladder emptying following this procedure. Bladder symptoms such as urinary frequency, urgency and nocturia can take up to three months to improve.
Robotic Surgery Prostate in Melbourne
At Melbourne Urology Centre, our specialist urologists Mr. Shekib Shahbaz and Mr. Tony de Sousa are highly experienced in the use of the da Vinci robotic surgical system, performing robotic prostate surgery Melbourne. They offer a completely individualized service and tailored treatment plan for each patient, and can discuss in detail your treatment options, including your suitability for robotic surgery for prostate conditions.
Our urologists always endeavour to treat patients as close to home as possible, so if you want to learn more about your eligibility for Melbourne robotic surgery for prostate conditions, please contact our rooms today.
References
Huynh, L. M., Ahlering, T. E., (2018), Robotic-assisted radical prostatectomy: a step-by-step guide, Journal of Endourology, 32(1),[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6071518/], accessed 26/07/21.
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 26/07/21.