Robotic Surgery for Prostate Cancer in Mumbai, India

What is Robotic Prostate Surgery

Robotic surgery for prostate cancer is an advanced, minimal-invasive procedure. It is performed using a robotic system, where the surgeon removes the prostate through many small keyhole incisions made in the patient’s abdomen. The surgeon uses a set of control panels to move robotic arms, which simulate his hands. 

Alternate Name of Robotic Prostate Surgery

Robotic-assisted radical laparoscopic prostatectomy

Body Location

Prostate gland

How to Perform Robotic Surgery for Prostate Cancer?

Robotic prostate surgery, or robotic prostatectomy, is a minimally invasive procedure usually performed by a team of experienced surgeons. A sophisticated system, called Da Vinci, enables the surgeon to work with precision and control, helping him remove the enlarged prostate. Several small keyhole incisions are made in the patient's abdomen. A three-dimensional endoscopy helps in giving a magnified view of the structure around the prostate (for example, blood vessels and muscles). After this, the cancerous prostate is removed with precision. During surgery, the surgeon sits on a computer console and operates small wristed instruments, which allow greater manipulation than the human wrist. A highly-skilled surgeon performs this surgery without touching the patient's body.

Preparation for Robotic Prostate Surgery

Certain pre-operative tests, and dietary and bowel preparations are required before surgery.

• Pre-operative tests and instructions:
  Before the operation, urine, blood tests, and

electrocardiogram profiling has to be done. Ingesting blood thinners 7-10 days before surgery must be avoided. Vitamin supplements and herbal medications should be avoided 10 days before surgery.

• Bowel preparation: Bowel preparation, or bowel prep, is generally recommended before surgery to prevent any chances of infection. Bowel preparation is commenced 24 hours before admission to the hospital.
• Diet: Plenty of fluids are to be consumed, as bowel preparation may lead to fluid loss. Before midnight, no drinking or eating solid food is recommended.
• Banking sperm: One of the side effects of surgery is loss of erection (erectile dysfunction), as prostatectomy could lead to the removal of seminal vesicles. In such cases, sperm can be banked for the future.

Robotic Prostate Surgery Procedure

Robotic surgery for laparoscopic prostate removal

Follow-ups after Robotic Prostate Surgery

After surgery, vigorous activity has to be avoided. Sitting still in one position and consumption of flatulence-causing food also has to be avoided. Post-operation, loose-fitting clothes are recommended. Catheter removal should be done only with the assistance of medical professionals. In case of any discomfort or pain, painkillers such as ibuprofen or Tylenol can be taken. A strong dose of a painkiller is not recommended as it might cause constipation. Oral antibiotics are prescribed upon discharge from the hospital until the catheter is removed. Other medications that can be taken upon discharge include stool softeners to prevent any occurrence of constipation.

Risks of Robotic Prostate Surgery

Generally, the surgery is very safe. However, some complications include:

• Bleeding: After catheter removal, slight bleeding is common.
• Blood clotting: Chances of blood clotting through robot-assisted prostatectomy are lower compared with traditional prostatectomy.

• Hernia: Hernia can occur but this happens rarely and does not cause significant harm.

• Heart attack: A rare occurrence in patients with a history of coronary heart disease.

• Impotence: Bundles of nerves on either side of the prostate might get damaged during the operation. Damage to nerves responsible for erection might lead to impotency.

• Permanent urinary incontinence: The bladder sphincter, a valve that aids in keeping urine in the bladder, might get damaged post-prostatectomy.

Recovery from Robotic Prostate Surgery

It normally takes three-four weeks for abdominal incisions to heal completely, so one should avoid lifting heavy objects after the operation. Some swelling can occur in the scrotum as well as the penis post-surgery, but this will get better after some time. The scrotum must not be rubbed dry but patted dry after a shower.

Daily activities such as climbing stairs and walking can be started. Heavy exercises such as cycling, jogging, and lifting weights must be avoided. One can return to work two-three weeks after the operation.