Prostate Cancer - Robot-Assisted Laparoscopic Radical Prostatectomy
Once the patient and his physician have considered all options and have decided to have surgery for prostate cancer, the conventional option is to undergo open radical prostatectomy. At The University of Chicago Hospitals, we offer an alternative to the open surgical approach. The laparoscopic robotic radical prostatectomy is a robot-assisted procedure using the Da Vinci robot system(Innovative Surgery; document pending),6 key-hole sized incisions distributed throughout the lower abdomen are made (FIG). The robot arms are placed through three of these keyhole incisions, the remaining incisions are for placement of instruments to hold and expose tissues during surgery. The surgeon is seated at a separate console a few feet away from the patient (FIG). He/she operates the robot arms and hands with a set of complex controls at the console. The surgeon is able to see the inside of the patient’s pelvis in a three-dimensional fashion. The seminal vesicles and the prostate gland are meticulously excised preserving the muscle mechanism for continence and the nerves responsible for sexual function. The cancerous prostate gland is placed into a plastic bag and removed through the incision above the belly-button. This incision is extended to approximately 2”, depending on the size of the prostate. Then, the bladder is connected to the urethra with precisely placed sutures.
After the operation, the patient feels much less pain since there is less trauma to the body, therefore will require less pain medication. Rarely (<1%) will a blood transfusion be required. The patients are usually eating regular diet and walking one day after surgery. They are usually discharged home on the first or second day after their surgery. The patients will go home with a urinary catheter, which are typically removed approximately 5 days following surgery. The patients are given 4-6 weeks off following their surgery before returning to work. However, with less pain and faster recovery from the laparoscopic approach, patients are able to resume their normal activities sooner.