Robot-assisted Prostatectomy
If you have been diagnosed with prostate cancer, your urologist may recommend a radical prostatectomy to remove the prostate gland and prevent the disease from spreading.
Advances in technology and techniques have made it possible to perform these procedures with the smallest of incisions and unmatched precision using the da Vinci Surgical System®. Ten-year survival rates of patients who have had a robot-assisted prostatectomy are greater than 90%.
We now offer robot-assisted prostatectomies to some patients using a new method to reduce pain, which makes it possible to perform the procedure on an outpatient basis. Called a TAP block, this minimally invasive, laparoscopic method to control pain was pioneered by UCI Health urologic surgeon Dr. David I. Lee, director of the Comprehensive Prostate Cancer Program.
Our specialists lead the way in performing successful robot-assisted prostatectomies with the da Vinci system. Our surgeons have achieved excellent results for our patients, including:
- Reduced blood loss
- Nearly zero blood transfusions
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- Low infection and complication rates
- Earlier recovery and return to work
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How robot-assisted prostatectomy works
Traditional open prostate surgeries involve a large incision in the lower abdomen to access the prostate. A minimally invasive procedure involves a few small incisions the size of a dime. The surgeon inserts small tubes called ports into the incision sites to create a channel for surgical tools and an imaging device.
The abdomen is inflated like a balloon to give the surgeon room to operate with the laparoscopic devices attached to the miniature robotic arms of the da Vinci system. The surgeon operates the arms at a remote console where the surgical field can be seen in magnified, three-dimensional detail. An assistant is seated by the patient’s side to help as needed.
Before the surgical procedure begins, the patient may be put to sleep with a general anesthetic. For patients who receive TAP — short for transversus abdominis plane — the anesthesia is injected into muscles in the abdomen to block nerves from sending any pain signals and help control pain post-surgery.
Once the prostate has been removed and margins are checked to ensure that all the cancer tissue has been eradicated, the robot arms are retracted and the surgeon sutures the tiny incisions shut.
Prostatectomy patients who receive the TAP block may be released home the same day. Patients who undergo general anesthesia for the procedure are discharged from the hospital about 24 hours after the procedure.
What to expect after surgery
For about a week after surgery, patients urinate through a catheter inserted at the beginning of the surgery. The catheter allows continuous drainage of the bladder into a small external collection bag that is emptied as needed. Once the catheter is removed, most men leak urine for a period of time.
Most patients are able to return to work in a few weeks and resume more vigorous activities in about six weeks.
Regaining function
Recovery of urinary continence can take weeks to as long as 18 months. Permanent incontinence after robot-assisted prostatectomy is rare when the procedure is performed by an experienced surgeon.
Patients with good erectile function before surgery have a good chance for full recovery if a nerve-sparing procedure was performed as part of the prostatectomy. Healing may take six to 24 months.
Questions? Call us at 714-456-7005.
