‘Radical’ means that the whole of the prostate is removed, rather than just a part of it, with the intention to cure prostate cancer. A prostatectomy is an operation to treat localised prostate cancer (cancer that has not spread outside the prostate gland). It is performed under general anaesthesia and involves removing the entire prostate gland, seminal vesicles (glands that p roduce semen) and possibly blood vessels, nerves and fat around the prostate. These are taken out to increase the likelihood of removing all the cancer cells. Once they have been removed, the urethra (tube that carries urine through the penis and out of the body) is then re-attached to the bladder. The pelvic lymph nodes ( small bean–like structures in the lymphatic system where the cancer may spread to in high risk disease) are also removed.
Robot assisted surgery is a technique that uses a robotic console (a control unit, the da Vinci® system) to help the surgeon during the operation.
A high magnification (x10) 3D camera allows the surgeon to see inside the abdomen. This is attached to one of the four arms on the robotic console and inserted into the abdomen through one of the keyholes. The other robotic arms can hold various instruments, which the surgeon will use to carry out the operation. The instruments are smaller (about 8mm) than those used for open surgery. Because of the robotic console and 3D camera, surgeon can carry out a precise operation in a smaller space, so a large incision is not needed.
The surgeon is in the same room, but away from the patient and he or she controls the robotic arms to perform the operation. It is important to understand that the robot is not performing the surgery. The surgeon still carries out the procedure, but the robotic console allows more controlled and precise movements during the operation.
The advantages of RRP include:
Robot-assisted techniques give the surgeon:
The magnification and the dexterity provided by the robot, assists in excellent visualization and preservation of neurovascular bundles around the prostate. These neura l structures carry the signals to the corpora for erectile function. Hence, preservation of these structures helps in preservation and early recovery of erectile function as well as early recovery of urinary control.
It is important to note that further treatment may be required, such as radiotherapy or hormonal therapy following surgery; if we find that the cancer has spread outside of the prostate. These findings are based on the final report from our pathologist.