Robot Assisted Radical Prostatectomy

Procedure Overview:

• Preparation: Before the surgery, you will undergo various tests, including blood work, imaging scans (MRI and PET Scans) and a prostate biopsy, to assess the extent of the cancer and your overall health.
• Anaesthesia: On the day of surgery, you will be given general anaesthesia (to put you to sleep) to ensure you are comfortable and pain-free during the procedure.
• Incisions: The surgeon will make 6 small (1cm) incisions in your abdomen to insert the robotic instruments and a camera. These instruments are controlled by the surgeon from a console in the operating room.
• Robotic Assistance: The surgeon controls the robotic arms using specialized hand and finger movements, which are translated into precise movements of the surgical instruments inside your body.
• Prostate Removal: The surgeon carefully removes the prostate gland along with any nearby cancerous tissue. The surrounding lymph nodes may also be examined to determine if the cancer has spread.
• Reconstruction: After the prostate is removed, the surgeon will reconnect the bladder to the urethra using sutures. This step aims to restore urinary continence.
• Prostate Removal: The prostate is removed by enlarging the midline incision to approximately 5cm.
• Closure: The incisions are closed with stitches or staples, and dressings are applied.
• Catheter: An in-dwelling catheter is left in your urethra (urine tube in the penis) for approximately 10 days to help the new bladder-urethra join to heal perfectly

Benefits:

• Precision: The robotic system provides greater dexterity and precision, allowing for more accurate removal of cancerous tissue while preserving healthy tissue.
• Less Invasive: Compared to traditional open surgery, robotic radical prostatectomy uses smaller incisions, which typically results in less pain, shorter hospital stays, and faster recovery.
• Less Blood Loss: The robotic approach has been proven to cause less blood loss and reduce the need for blood trasnsfusion
• Faster Recovery: The minimally invasive nature of this procedure often leads to quicker recovery times and earlier return to normal activities.

Risks and Considerations:

• Infection (urine, skin, lung) (5%)
• Bleeding requiring blood transfusion ( 3%)
• Long Term Urinary incontinence (5%)
• Erectile dysfunction. Depends on age and pre-operative erectile function and the degree to which the nerves of erection can be spared. Dr Menogue will explain this and how it relates to your personal situation.
• Injury to surrounding organs or structures (1-2%)
• Formation of scar tissue
• Risks associated with anaesthesia

Recovery:

• You will need to stay in the hospital for a day or two after surgery.
• Your catheter will be removed under Dr Menogue’s guidance approximately 10 days after surgery
• Physical activity and heavy lifting should be avoided for 4 weeks.
• Driving should be avoided for 4 weeks
• Recovery of bladder control and erectile function will be aided by physiotherapy, medications and in some cases injections and penile pumps. Dr Menogue will guide you through this process.
• Follow-up appointments will be scheduled to monitor your recovery and discuss any concerns.

Robotic radical prostatectomy is a modern surgical technique that offers precise removal of the prostate gland for the treatment of localized prostate cancer. While it offers many benefits, it’s important to discuss the procedure thoroughly with Dr Menogue and his team including its potential risks and expected outcomes, before making an informed decision about your treatment options. Dr Menogue and his team will guide you through every step of the process and help you achieve the best possible outcome for your health and quality of life.