urology Robotic Radical Prostatectomy

In the recent decades, prostate cancer has become very common. Though inference can be drawn from the data available across various platforms that mortality rates from prostate cancer are declining, the need for proper screening makes managing clinically localized cancer a difficult job. But all of that is going to change and the tides are going to turn once again with the advent of nerve-sparing radical prostatectomy. The open surgery has now gained ground as the complications of radical prostatectomy, that is urinary incontinence and impotence are slowly declining.

How did Laparoscopic Prostatectomy come into view?

The first successful surgeries in laparoscopic radical prostatectomies were performed by Schuessler in 1992 and 1997. The technology remained dormant for quite some time as it had no such gains over the radical retropubic prostatectomy. Over a period of time with improvement of technology and techniques results of surgery improved and soon, laparoscopic radical prostatectomy started to gain a lot of ground and the whole world started accepting this new technique.

What is Robotic Radical Prostatectomy and how is it helpful

Robotic assisted radical prostatectomy is simply laparoscopic prostatectomy performed with a help of ROBOT. Ports are set up by the surgeon and then the instruments are connected to the Robot. Then the surgeon operates through a console like a set of joystick sitting away from the operating table.. Highly advanced clinical technologies are combined with the precision of the robotic surgery in offering amazing surgical results. A 3D operating vision system improves the depth of anatomy and the magnification thus precision of the surgery.

Why is robotic radical prostatectomy should be considered?

The surgical field gets magnified about 15 times through the 3D vision system. With this the anatomy becomes very clear and precise to the surgeon and thus the ability of the surgeon is improvised in recognizing and controlling the small blood vessels, which reduces blood loss. The precision of the surgery increases. The arms remain steady and the wrists make it easier for surgeons to manipulate tissues and work from different angles. This will help in precisely recognizing the neurovascular bundles which is important in for restoring the potency and sparing the urinary sphincter and thus the urinary continence. Thus over all surgical out come is far superior to open surgery.

Robotic Radical Prostatectomy - What happens?

The patient would generally be asked to have a simple liquid diet the day before surgery. Though every case is unique, drinking anything after midnight the day before is prohibited. Taking medications would also be needed to be stopped. It is important to listen to every instruction of the doctor. General anaesthesia would be given to the patients, followed by antibiotics to help prevent infection. Small incision, Less bleeding, precise cutting will result in less morbidity and early discharge.

What is the procedure after surgery?

Early Walking is encouraged after surgery and heavy exercise is postponed for a month. Different exercises are taught to the patients called Kegel's exercises to help the patients control urine. Generally patient has complete continence and potency by end of six months.

The Robotic Radical Prostatectomy has made the entire procedure quite smooth. The process is sophisticated and encourages patients and removes all doubts and hesitations.


Authored By : Dr. Mahendra Jain

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Dr. Mahendra Jain

MBBS.MS.MCh.DNB Consultant Urologist

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