Robotic Prostatectomy: Modern Prostate Cancer Surgery

How common is prostate cancer?

Prostate cancer stands as one of the most common malignancies affecting men worldwide. In the UK, 1 in 8 white men and 1 in 4 black men are affected.

What is a robotic prostatectomy?

Robotic prostatectomy, also known as robot-assisted laparoscopic prostatectomy, is a sophisticated surgical technique that utilises robotic systems, such as the da Vinci Surgical System, to excise the prostate gland as a treatment for prostate cancer. The surgeon remotely manipulates the robotic arms from a console, benefiting from a magnified, three-dimensional, high-definition view of the operative field. The system's precision engineering translates the surgeon's hand gestures into minute, exact manoeuvres of the surgical instruments within the patient's body.

Is robotic surgery better than traditional surgery?

The critical distinctions between robotic and traditional open prostatectomy include:

• Precision: The robotic apparatus offers heightened precision, particularly beneficial within the restricted pelvic space.
• Incision Size: Smaller incisions are needed, decreasing the likelihood of infection and diminishing blood loss.
• Visualisation: The system affords the surgeon a superior vantage point with enhanced 3D imagery of the surgical site.
• Dexterity: Robotic arms possess a range of motion surpassing that of the human hand, adding flexibility to the procedure.
• Recovery: The minimally invasive nature generally results in faster recovery and reduced postoperative discomfort.

What are the advantages of Robotic Prostatectomy?

The adoption of robotic prostatectomy carries several potential advantages:

• Lower Blood Loss: Precision and smaller incisions typically lead to less intraoperative bleeding and reduced transfusion requirements.
• Infection Risk: Postsurgical infection risk is lower than larger, open incisions.
• Accelerated Recovery: Patients often report a swifter return to daily activities.
• Pain Reduction: Postoperative pain is usually less severe and resolves more quickly.
• Oncological Outcomes: There's a possibility for improved cancer control due to the enhanced surgical precision, though research is ongoing.

What is the recovery after robotic prostatectomy?

Immediate Postoperative Phase

• Patients may expect a brief hospital stay, often one night.
• A urinary catheter is typically necessary for approximately one to two weeks following the procedure.
• Light physical activities can generally be resumed within several days, with more vigorous exertion postponed for up to six weeks.
• Regular postoperative appointments are crucial to monitor for potential recurrence of cancer or surgical complications.
• Pain is commonly controlled with paracetamol and NSAIDs.

What are the risks and complications of a robotic prostatectomy (RARP)?

While robotic prostatectomy is generally safer, it is not devoid of risks:

• Infection: The possibility of infection exists, albeit at a lower incidence.
• Urinary Incontinence: Some patients may face short or long-term urinary control issues.
• Erectile Dysfunction: Nerve-sparing techniques may not always be viable, potentially affecting sexual function.
• Bleeding: Excessive bleeding is a less frequent but still potential risk.
• Positive Surgical Margins: There's a chance of incomplete cancerous tissue removal.
• Anastomotic Complications: Difficulties may arise at the junction between the bladder and the urethra.
• Thromboembolic Events: There's a risk of blood clots forming in the deep veins or lungs.
• Pelvic Pain: Some patients may experience chronic pain in the pelvic region postoperatively.

Is robotic prostatectomy the best treatment option?

Robotic prostatectomy represents a significant advance in prostate cancer treatment, offering a fusion of technology and surgical expertise to potentially improve patient outcomes. While it introduces a promising avenue, the decision to opt for this modality should be made after thorough consultation with a healthcare provider, considering the individual's unique medical context and the procedure's inherent risks and benefits. Needless to say chossing your prostate surgeon is key.