Robotic Prostatectomy

Prostatectomy is the medical term for surgery to remove a man’s prostate gland. It is a common treatment for men with early prostate cancer. And it is one of several treatment options for a condition called benign prostatic hyperplasia (enlarged prostate). 

Depending on your medical need, your surgeon may remove some or all of your prostate. He or she may also need to remove nearby tissue or lymph nodes.

Types of prostatectomy include:

Radical prostatectomy

Radical prostatectomy removes the entire prostate gland and seminal vesicles (a pair of small glands that help produce semen). Your surgeon may also remove some surrounding lymph nodes. Radical prostatectomy is the main type of surgery used to treat prostate cancer that hasn’t spread. 

Simple prostatectomy

Simple prostatectomy is a treatment for enlarged prostate, which can block urine flow. It only removes the part of the prostate preventing normal urination.

Scripps offers the full range of prostatectomy procedures, including the latest minimally invasive techniques that may reduce pain and recovery time. These include: 

Retropubic radical prostatectomy

Retropubic radical prostatectomy is a type of “open” surgery. Your surgeon removes your prostate and nearby tissue through a large cut (incision) in your lower abdomen. 

Perineal radical prostatectomy

Perineal radical prostatectomy is also considered open surgery. Your surgeon removes the prostate through an incision between your anus and the base of your scrotum.

Laparoscopic radical prostatectomy

Laparoscopic radical prostatectomy is a minimally invasive procedure that uses several tiny incisions (instead of one large incision). Your surgeon guides a thin, flexible tube mounted with a tiny camera through these incisions, so he or she can see inside your lower abdomen. The prostate is then removed through one of the abdominal incisions.

Robotic radical prostatectomy

Robotic radical prostatectomy is nearly identical to laparoscopic prostatectomy. However, during robotic surgery, your surgeon doesn’t hold surgical instruments in his or her hands. Instead, the instruments are attached to robotic arms, which your surgeon controls from a nearby computer console. 

Simple prostatectomy

Simple prostatectomy can also be performed using open, laparoscopic or robotic approaches. 

Not everyone is a candidate for minimally invasive surgery. Your doctor will help you understand which surgical options are best for you.

All minimally invasive surgical procedures require fewer, or smaller, incisions. But robotic prostatectomy is different from laparoscopic prostatectomy. It uses robotic technology to increase precision and control, and to magnify the prostate and surrounding tissue and nerves.

During robotic prostatectomy, surgical instruments (and a tiny camera) are attached to robotic arms. These arms are controlled by a specially trained surgeon from a nearby computer console. 

As your surgeon moves his or her hand, wrist and fingers, the robotic arms perform the same movements in real time. Not only do the robotic arms mimic delicate movements, they can bend and rotate in ways a human hand cannot.

The computer console also displays a high-definition, close-up view of the surgical site. Throughout the procedure, your surgeon can see inside your body in three dimensions. This is another key difference – during laparoscopic prostatectomy, surgeons only have a two-dimensional view of the surgical field.

During the procedure, your surgeon will access your prostate through several small incisions in your lower abdomen. If you’re having a radical prostatectomy, your surgeon will carefully separate your prostate from surrounding nerves and blood vessels. Then he or she will remove the prostate, nearby tissue or lymph nodes through one of your abdominal incisions. If you’re having a simple prostatectomy, your surgeon will only remove the part of your prostate causing urinary symptoms. 

Robotic surgery allows your surgeon to make tiny, precise movements that may lower the risk of nerve damage. Subsequently, this may lower your risk of bladder or erection problems.

In most cases, men who have a robot-assisted prostatectomy can return home the day after surgery. You may be able to resume normal activity within two to four weeks. 

In comparison, men who have open prostatectomy may need to stay in the hospital for several days following their procedure. And recovery can take four to six weeks. 

Everyone recovers differently following surgery. Your recovery time will depend on several factors, including your age, overall health and the type of prostatectomy you had.

It’s important to check with your health plan before having any surgical procedure. Many, but not all, insurance companies cover robotic surgery (including robotic prostatectomy).

Those that do cover robotic surgery often categorize it as “robot-assisted minimally invasive surgery.” In most cases, if your plan covers minimally invasive surgery, it will also cover robot-assisted surgical procedures.

Robotic prostatectomy may offer several benefits compared to traditional, open surgery. These include: 

• Nerve-sparing techniques that may help preserve bladder control and sexual function
• Reduced risk of complications, including surgical site infection
• Less blood loss (reducing the need for a blood transfusion)
• Less pain (reducing the need for pain medication)
• Smaller, less visible scars
• Shorter hospital stay
• Faster recovery

Like all surgery, robotic prostatectomy also carries risks. These include:

• Damage to nearby organs and tissue, including the bladder
• Long-term urinary problems, such as incontinence
• Erectile dysfunction
• Excessive bleeding
• Surgical site infection 
• Complications from anesthesia
• Equipment failure