Robotic Prostatectomy

A robotic prostatectomy is a type of prostate surgery in which a doctor uses robotic instruments to remove all or part of the prostate gland.

The surgeon controls the robotic arms from a console near the operating table, guiding the instruments with precision.

Robotic prostatectomy is most commonly used to treat prostate cancer. In some cases, this procedure is also used to relieve urinary problems caused by an enlarged prostate (BPH).

Although it’s called “robotic,” the system doesn’t operate on its own. The surgeon remains in complete control the entire time.

Robotic prostatectomy consultations are available in the Charlotte, NC and West Columbia, SC areas with experienced urologic surgeons.

In a traditional open prostatectomy, the surgeon makes one large incision to reach the prostate. A robotic prostatectomy uses a minimally invasive approach instead.

Several small incisions, each about the width of a finger, are made in the lower abdomen. A small camera and narrow instruments are inserted through these openings.

The surgeon views the surgical area on a magnified 3-D screen and uses robotic arms to move the instruments. The arms allow for more flexibility than the human wrist can provide.

Because of this technique, robotic surgery usually results in:

• Smaller scars
• Less blood loss
• Less pain
• A quicker recovery than open surgery

There are a few different ways the procedure can be done, depending on the reason for surgery and your general health.

1. Robotic radical prostatectomy

This operation is used for prostate cancer that is confined to the prostate gland. The surgeon removes the entire prostate along with nearby tissues. They may also remove a few lymph nodes, which are small glands that filter fluid and may show whether cancer has spread. This is often called a robot-assisted radical laparoscopic prostatectomy.

2. Nerve-sparing prostatectomy

In some cases, the surgeon can perform a nerve-sparing technique. The goal is to preserve the tiny nerves that control erections while still removing all the cancer. Whether this can be done depends on how close the cancer is to the nerve bundles. If the tumor is too close, removing those nerves may be necessary to achieve complete cancer control.

3. Simple robotic prostatectomy

When surgery is done for BPH, the goal is not to remove the entire prostate but rather the inner portion that is blocking urine flow. The outer part of the gland is left in place. This procedure helps relieve urinary symptoms. It’s sometimes called a robotic simple prostatectomy.

This procedure is typically reserved for men with very large prostates when other treatments are not effective or suitable.

While results vary, most men experience:

• Smaller incisions and faster healing
• Less pain and blood loss than with open surgery
• A shorter hospital stay

The procedure is done under general anesthesia, meaning you’ll be asleep and won’t feel pain. The operation usually takes two to four hours.

Several small incisions are made in your lower abdomen. A thin camera gives the surgeon a magnified, three-dimensional view of the prostate.

Robotic instruments are inserted through the ports and controlled by the surgeon from a console. The prostate and, in cancer cases, nearby tissue or lymph nodes are carefully removed. A small drain or catheter is placed to allow urine to pass while healing begins, and will usually remain in place for 1 to 2 weeks.

Most men return to light activity within a couple of weeks and to regular work and exercise in about four to six weeks, depending on how they feel.

A robotic prostatectomy is a safe and effective option for many men with prostate cancer. Although it’s less invasive than traditional surgery, recovery still takes time and patience. Asking questions and working closely with your urology team can help you prepare for surgery and achieve the best possible results.

1. What happens to semen after the prostate is removed?

During a radical prostatectomy, the prostate and seminal vesicles, which make most of the fluid in semen, are removed. After surgery, you’ll still be able to orgasm, but there will be little or no fluid released. This does not affect your ability to enjoy sexual pleasure, though it does mean you can no longer father children naturally.

2. Will I lose control of my bladder after surgery?

It’s common to have some urinary leakage after surgery, especially when coughing or exercising. This usually improves within a few months. Doing pelvic-floor exercises and following your doctor’s recovery plan can speed up the improvement process. Most men regain good bladder control within six to twelve months.

Robotic Prostatectomy consultations are available with all of our providers.