Robotic prostatectomy
Robot assisted surgery for prostate cancer
Things you need to know about Robotic prostectomy
What is Robotic prostatectomy or robotic prostate cancer surgery? When it is recommended?
Prostate cancer is one of the most common cancer diagnosed in men. If the cancer has not spread outside the prostate gland, surgical removal of the prostate and surrounding tissues is the standard choice of treatment. The main type of surgery for prostate cancer is a radical prostatectomy.
Conventionally, radical prostatectomy was carried out using open surgery. However, with the advent of recent technologies radical prostatectomy is carried out using minimal invasive techniques such as laparoscopy and robotic prostate surgery.
In the laparoscopic surgery, a surgeon performs the procedure holding instruments and can view the surgical area through an endoscopic camera, which projects an image on monitor. However, the procedure is associated with limitations in certain situations.
In the robot assisted prostate cancer surgery, the surgery is done using a robotic system. During the surgery, the surgeon uses the control panel in the operating room to move the robotic arms and operate through several small incisions (cuts) in the patient’s abdomen. The robotic arms allow freedom of motion similar to the surgeon’s hand; an improvement over the traditional laparoscopic tools.
Prostate Cancer
What is robot assisted surgery?
Robotic surgery, or robot-assisted surgery, is an advancement in surgical techniques where a surgeon uses a computerized robotic arm with small tools attached to it to carry out complex surgeries.
Robotic surgical system provides the surgeon a high-definition, magnified (12×), 3-D view of the surgical site.
The surgical instruments are controlled by the surgeon using the console, to direct special surgical instruments which are smaller in size, and more flexible than the human hand.
The robot does not perform the surgery on its own. The movement of the surgeon’s hand just mimicked by the instruments attached to the robotic arms, while this is completely controlled by the surgeon. Robot assisted surgeries offer precise action that is devoid of hand tremors, enabling the surgeon to perform the most complex procedures with enhanced precision, dexterity and control
What is robotic prostatectomy or Robotic prostate cancer surgery
What are the advantages of robotic prostatectomy over open prostate cancer surgery?
Technical advantages: Robotic prostate cancer surgery can be considered superior to the conventional open prostate cancer surgery in many ways. Some of the technical advantages of the procedure are:
- The movements of the robotic arms are free, precise, fine and devoid of tremors.
- There is improved visualization of the surgical site with the mobile camera system that provides a three-dimensional, magnified view thus allowing precise removal of the prostate.
- The procedure offers the advantages of minimally invasive surgery while sparing nerves to preserve sexual potency and sparing continence to preserve urinary control.
Improved patient outcomes: The robot assisted procedure is performed using five or six keyhole incisions, hence it offers the advantages of :
- Faster healing
- Reduced blood loss
- Less postoperative pain
- Earlier removal of catheter (1 week typically)
- Shorter recovery time
- Reduced hospital stays
- Quicker return to normal activity (one to two weeks) and work (two to three weeks)
- Smaller incisions and less scarring
- Low risk of incontinence (ability to control the bladder and bowels)
- Able to get an erection again sooner
- Get their bladder control back quickly.
- Smaller incisions less scarring
What are the risks involved in robot assisted prostatectomy?
Robot assisted prostatectomy surgery involves some degree of risks, although relatively minor such as a –
- Risk of infection
- Reactions to anesthesia and related products
- Blood clots in the legs or lungs and other complications
What are the success rates of robot assisted prostatectomy surgery?
Although the response to robot assisted prostatectomy surgery is dependent on the body’s inherent characteristics and the patient’s medical condition. Compared to laparoscopic radical prostatectomy, robot-assisted radical prostatectomy is associated with:
- Lower complication rate
- Better potency
- Higher continence rate
- Reduced chances of rising PSA blood levels and cancer relapse (biochemical recurrence)
What factors should be considered while choosing a hospital for robot assisted prostate cancer surgery?
Prostate cancer surgery is a major surgery and for the best possible results, it is essential to choose a center with state-of-the-art robotic surgery facilities, expert robotic urosurgeon and health care team that are experienced in performing successful radical prostatectomy. Additionally, it is also important to ensure that the hospital has the necessary infrastructure like diagnostics, pharmacy, OT and ICUs to support the pre-operative and post-operative needs.
State-of-the-Art Robotic Surgery Facilities
What factors govern the cost of robot assisted prostate cancer surgery?
The cost of surgery usually depends on various factors such as:
- Expertise of surgeonand team.
- Surgery facilities and equipment.
- Length of surgery and post surgical complications
- Hospital stays.
- Diagnostic tests ans medicines.
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References
- Surgery for Prostate Cancer. Available at https://www.cancer.org/cancer/prostate-cancer/treating/surgery.html. Accessed on March 29, 2018.
- Robotic surgery for prostate cancer. Available at http://www.cancerresearchuk.org/about-cancer/prostate-cancer/treatment/surgery/types/robotic-surgery-for-prostate-cancer. Accessed on March 29, 2018.
- Robotic Prostate Surgery. Available at https://my.clevelandclinic.org/health/treatments/17446-robotic-prostate-surgery. Accessed on March 29, 2018.
- Lee SH, Seo HJ, Lee NR, et al. Robot-assisted radical prostatectomy has lower biochemical recurrence than laparoscopic radical prostatectomy: Systematic review and meta-analysis. Investing Clin Urol. 2017 May; 58(3): 152–163.
