Jorge Gutiérrez Aceves, M.D.
Urology, Endourology and Robotic Surgery
A radical prostatectomy is a surgical procedure in which the prostate gland in completely removed along with the seminal vesicles and sometimes even the lymph nodes surrounding the gland. Its main objective is to cure and control prostate cancer.
The robotic-surgical system called “da Vinci®" has revolutionized prostate cancer treatment through robotic prostatectomy with a minimal invasive procedure with better precision and visualization of the patient’s anatomy. All of this, results in the patient’s recovery process in both short and long term.
Robotic procedure is based on laparoscopic surgery assisted by the “da Vinci®" robotic system; done through small incisions, robotic surgery causes less post-operational pain and a faster recovery. Articulated instruments, tremor control and a 3D high definition vision magnifier, help the surgeon operate with better precision, resulting in less blood loss, and better odds of preserving urinary continence and sexual performance.
Those who are diagnosed with localized prostate cancer and is locally advanced, and who are otherwise satisfactorily healthy will be able to undergo this surgical procedure.
A previous medical check-up is required and done by our medical team. Usually, hospital admittance is done on the day of surgery. On the day prior to the surgery, the colon is cleansed and prepared with an enema. On surgery day, the patient is moved to the operating room where the “da Vinci®" robotic surgical system is located. General anesthesia is required for the procedure. The surgical team starts the procedure by making multiple small incisions (about 1cm wide) on the abdomen; they well then insert plastic tubes that will serve as access channels into the abdomen for the tridimensional camera and the robotic “da Vinci” arms. Once they’re in place, the surgery can start, in which the head surgeon has full control through a robotic console, assisted by a second surgeon who is right next to the patient. The surgery lasts about three hours.
On the surgery’s last stage, a urinary catheter or a probe is set into place after the bladder’s reconstruction. At the same time, a drain is connected from the surgical area to the outer part of the body so that there can be control over the produced liquids in the area. The probe will be in place for about 5 to 7 days, which is correlated to the bladder’s healing time. The drain will only be in place from 2 to 3 days, depending on the amount of liquid produced.
One of the advantages of robotic surgery is minimum invasion, with less post-operational pain and a faster recovery; which makes the hospital stay to be between 24 and 48 hours long in the majority of cases. The possibility to have an erection and to be sexually active is related to the erection’s quality prior to the surgery. However, the ability to sustain prior sexual capacity improves significantly after robotic surgery compared to other surgical procedures. After surgery, certain exercises and medical treatments are done as part of the penile rehabilitation process.
Urinary continence recovery after prostate surgery is singular to each patient. The vast majority achieves this 3 months after the surgery. After surgery and the urinary probe removal, pelvic exercises are done so to achieve urinary continence faster and more effectively.
Nowadays with the new surgical techniques, few are the patients who present these unwanted effects after surgery: urinary incontinence and/or erectile dysfunction. If you wish to have more information about the procedure, please contact us and one of our team’s doctors will answer your questions.
Today, robotic prostatectomy is the most used procedure in the US and has a steady growth in Europe. All of this thanks to the excellent results of cancer control with minimum invasion. It is considered as the standard procedure to handle localized prostate cancer.
Benefits of Robotic Prostatectomy
For the patient:
Fast reinstatement to usual activities
Shorter hospitalization time
Less risk of urinary incontinence and impotence
Less post-operational pain
Less complication risk
Fewer surgical scars
For the doctor
A 3D high resolution color image can be given
Placing a computerized equipment between the surgeon’s hands and the instruments
Enhance the surgeon’s skills on the difficult aspects of the procedure
Intercommunication between the console and the laparoscopic assistant