Robot-Assisted Prostate Surgery: About the Procedure

A Less Invasive Alternative to Radical Prostatectomy

Comparision of open prostatectomy incisions vs. laparoscopic incisionsOn the left, the red line indicates the location of the incision for traditional open prostatectomy. On the right, the red dots indicate the locations of 5 to 12 millimeter "keyhole" incisions made for robot-assisted surgery.

Radical prostatectomy, or removal of the prostate gland, traditionally has been performed by making a 6- to 10-inch incision in the lower abdomen to remove the cancerous gland. Using the da Vinci® Si HD Surgical System, however, a robotic laparoscopy enables the removal of the prostate through five small incisions, each five to 12 millimeters in the lower abdomen. This revolutionary technology also provides the surgeon with a magnified "inside the body" view using a 3D video console to display the telescopic image.

The robot-assisted operation results in less blood loss during the procedure, less pain and a shorter recovery time.

How the Surgery Works

  1. Five small incisions ("keyholes") 5 to 12 mm long are placed into the lower abdomen.
  2. The abdominal cavity is filled with several liters of carbon dioxide gas to create a working space to perform the surgery.
  3. A telescope connected to a camera and several working instruments are passed through the keyholes. This allows the surgeon to have an enlarged view of the inside the body through a video headset on the surgeon console that will guide him through the procedure.
  4. The prostate and seminal vesicles are freed from surrounding organs (including the bladder, urethra, rectum and neurovascular bundles, when appropriate), removed through a small incision and placed in a sterile retrieval bag for the pathologist to evaluate for an accurate diagnosis.Depending on your PSA, Gleason's sum and clinical stage, pelvic lymph nodes may also be removed to evaluate for spread of cancer (metastasis).

Typically, the length of the operation is two hours and the pathology report is ready in five to seven working days.

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