Robot assisted minimally invasive keyhole surgery carried out by a specially trained surgeon to remove a cancerous prostate gland.
Prostate cancer is the most common malignancy in males in the UK, with almost 50,000 new cases diagnosed every year. 1 in 6 UK males will be diagnosed with prostate cancer in their lifetime. Prostate cancer accounts for 13% of all cancer deaths in males in the UK.
Robotic radical prostatectomy
Surgical removal of the prostate, radical prostatectomy, remains one of the gold standard treatments of choice for men with clinically significant localised prostate cancer. The aim of a radical prostatectomy is to remove the entire cancerous gland with a minimal chance of leaving any cancerous cells behind.
Traditionally, radical prostatectomy was performed using an open surgical technique. This transitioned to keyhole laparoscopic techniques. Then more recently developed into keyhole robotic approaches, using the Da Vinci robotic-assisted surgical system.
Robotic radical prostatectomy is one of the latest major advances in prostate cancer surgery. By incorporating sophisticated wristed technology, the Da Vinci robotic system offers surgeons the ability to operate, dissect, and suture with the facility of a human wrist.
The surgical system also provides the surgeon with an unprecedented view of the operative area and periprostatic anatomy thanks to the 10x magnified, 3D high-definition image.
The combination of enhanced movement and visual acuity means this less invasive, more precise form of surgery has significant benefits for the patient:
- Keyhole incisions mean less noticeable scars and shorter operative time.
- Dramatic reduction in operative blood loss and pain.
- Fewer complications such as infection.
- Shorter hospital stays.
- Faster recovery times and return to normal activity.
- Improved cancer control.
- Earlier urinary continence following surgery.
- Better preservation of sexual function.
In following video Mr Philip Charlesworth of The Urology Partnership provides a comprehensive overview of robotic surgery and the benefits this offers to patients.
Robotic Prostatectomy Procedure
Using the Da Vinci surgical system
The sophisticated Da Vinci robotic system greatly extends the capabilities of the surgeons’ eyes and hands enabling for a more delicate and precise operation. The robotic system can achieve a far greater range of motion than the human hand and built-in tremor-filtration technology helps to move the instruments smoothly and accurately.
During surgery, the surgeon operates using the console positioned next to the patient. The surgeon can see the operative field and the prostate and periprostatic anatomy in a 3D HD view and control the console. The console diminishes any human hand tremor, precisely controls the four robotic arms, and replicates the surgeon movements.
The first part of the surgery is to gain access to the abdomen. Access is granted by 6 small incisions, through which a trocar is inserted, which allows continuous access to the surgical field. The robotic arms are then attached to these trocars, through which the robotic instruments are introduced.
Next, the prostate and both vasa and seminal vesicles are exposed and detached from its surroundings, including the urinary bladder and rectum. At this point care is taken, if possible, to preserve the urinary sphincter and the neurovascular bundles responsible for erection. After removing the prostate, the continuity of the urinary system is achieved by suturing the bladder with the urethra over a catheter, which is kept in for several days.
The surgery typically lasts about 2 -3 hours and is carried out under a general anaesthetic. At the end of the surgery, a surgical drain is kept in along with a urinary catheter. The drain will be removed the next day and the patient discharged home with a catheter for 4-7 days.
Berkshire Robotic Centre was recently featured on BBC South which provides further insight into a robotic prostatectomy using the Da Vinci system.
Experienced hands behind the robot
Several studies around the world have shown that surgeon experience is one of the most important factors in achieving the best oncological, functional, and sexual outcomes following robotic prostatectomy. At The Urology Partnership, our surgeons have a combined experience of well over 1000 robotic cases.
We also have specialists in advanced sparing techniques that enhance preservation of the important nerves and structures surrounding the prostate responsible for continence and sexual functioning.
If you are interested in a robotic prostatectomy, please get in touch with the Urology Partnership.
You may either complete the form below to arrange a consultation with one of our consultant urological surgeons. Or call the clinic on 0118 920 7040 for help and advice.
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