Facing any kind of urologic surgery creates a great deal of anxiety for most men. Among your concerns is: "Will my body function normally following surgery?" Traditional open urologic surgery - in which large incisions are made to access the pelvic organs - has been the standard approach when surgery is warranted. Yet, common drawbacks of this procedure include significant post-surgical pain, a lengthy recovery and an unpredictable, potentially long-term impact on continence and sexual function. The da Vinci system, a minimally invasive approach that uses the latest in surgical and robotics technologies, is ideal for delicate urologic surgery. This includes prostatectomy, in which the target site is not only tightly confined but also surrounded by nerves affecting urinary control and sexual function.
What exactly is prostate cancer?
Prostate cancer is a disease in which malignant (cancer) cells form in the tissues of the prostate. The prostate is a gland in the male reproductive system located just below the bladder and in front of the rectum. It is about the size of a walnut and surrounds the urethra (the tube that empties urine from the bladder). The prostate gland produces fluid that makes up part of the semen.
Approximately 16 percent of American men will be diagnosed with prostate cancer sometime in their life. Treatment options and prognosis depend on the stage of the cancer, the Gleason score, and the patient's age and general health. With greater public awareness, early detection is on the rise and mortality rates are declining. Additionally, new advances in medical technology are enabling cancer victims to go on to live active and productive lives after their treatment. Consult with your doctor for advice on the options that are available to treat your specific condition.
Benefits of Robot-Assisted Prostatectomy:
- Significantly less pain
- Less blood loss
- Less scarring
- Shorter recovery time
- A faster return to normal daily activities
- In many cases, better clinical outcomes
What to expect from a Robot-Assisted Prostatectomy
Undergoing any sort of surgery can cause anxiety. Pursuing treatment with a surgical approach that is still new and unknown to many patients may further raise a number of questions. This section explains what happens before, during and after a robotic-assisted surgery using the da Vinci Surgical System, and aims to dispel some of that anxiety by providing clear information on what you should expect from your procedure.
- Initial Appointment
Many men simply go to a primary care physician for a routine check-up, only to get a call a few days later to report that something called an "elevated PSA" had shown up in their laboratory results and that further testing will need to be conducted by a urologist.
- Laboratory Results
The exam likely consists of a standard digital rectal exam (DRE), in which the doctor manually palpates the prostate by way of the rectum. Even if the urologist detects nothing abnormal, he/she schedules a biopsy to be on the safe side. The biopsy is performed by inserting a tubular structure in the rectum, from which projectile needles collect five to six "cores" of tissue from each side of the prostate. Although many patients tolerate the biopsy without medication, the urologist may offer something to alleviate any discomfort and/or anxiety associated with the procedure.
- Treatment Options
If the patient has an early diagnosis of prostate cancer, there is usually a range of treatment options. These may include conservative management, radiation therapy with external bream or brachytherapy, cryosurgery and prostatectomy - surgical removal of the prostate. The treatment options will depend on a number of factors, including the stage of the disease, the age and health or personal preference of the patient.
The patient will have a physical examination and discuss the various types of anesthesia with the anesthesiologist. This visit is arranged by the doctor and will likely occur the week before surgery. The evening before surgery the patient follows instructions for bowel preparation as provided by the doctor.
- Day of Surgery
Shortly before the operation, anesthesia is administered and the patient goes to sleep for the duration of the operation, which typically lasts two to four hours. The procedure begins when the patient's abdomen is inflated with carbon dioxide gas, creating an operating space for the surgeon. Next, six small incisions, 1/4 to 1/2 inches in length, are made in the patient's abdomen and ports are inserted to keep the incisions open.
If you would like to explore whether you are a candidate for robot-assisted prostatectomy, ask your doctor. For a referral to a Chilton physician, visit or online physician referral service or call 1-888-CHILTON.
While clinical studies support the effectiveness of the da Vinci System when used in minimally invasive surgery, individual results may vary. Surgery with the da Vinci Surgical System may not be appropriate for every individual. Always ask your doctor about all treatment options, as well as their risks and benefits.
For additional information on minimally invasive surgery with the da Vinci Surgical System visit www.davincisurgery.com.
Surgeons who Perform Robot-Assisted Prostate Surgery at Chilton: