Urology, Robotic Surgery and Urologic Oncology
JEANNIE SU, M.D.
Robotic Prostatectomy
Robotic assisted radical prostatectomy is a minimally invasive surgical procedure involving the removal of the prostate gland to treat prostate cancer.
How is a robotic prostatectomy performed?
During a multi-port robotic prostatectomy, Dr Su carefully insert smalls, 5-12 millimeter robotic arms—each about the diameter of a dime—into separate small incisions in the patient's abdomen. The arms are equipped with a stereoscopic camera that allows Dr Su to view the procedure in three dimensions and specialized laparoscopic surgical instruments that respond precisely to every movement of her hands.
During the procedure, the entire prostate will be removed. Based on the extent and grade of the disease, the surrounding lymph nodes may also need to be removed.
Intuitive Da Vinci robot
What is a robotic nerve-sparing radical prostatectomy?
The extent of the disease and the location of the cancer with respect to surrounding structures will determine if the robotic radical prostatectomy can be a nerve-sparing procedure, known as a robotic nerve-sparing radical prostatectomy. Utilizing this approach will be discussed before surgery, and the ultimate decision to use a nerve-sparing technique will be made during your surgery.
For patients with clinically localized prostate cancer, nerve-sparing robotic prostatectomy provides patients with a safe and minimally invasive technique for removal of the prostate gland while preserving as much of the surrounding nerve structures responsible for penile erections. Furthermore, various methods can be performed to optimize continence.
Overall this minimally-invasive approach, whether single-port or multi-port, boasts the advantage of smaller incisions, reduced pain, less blood loss, transfusion rates, and reduced hospital stay. In select patients with locally invasive or metastatic cancer, morbid obesity, bleeding tendencies, or severe heart or lung problems, robotic prostatectomy may not be advised.
Prostatectomy candidates
What type of patients are candidates for prostatectomy?
Robotic prostatectomy is used to treat patients who have clinically localized prostate cancer.
Who is not considered a good candidate for prostatectomy?
Patients with a history of advanced age, extensive abdominal surgery, radiation, pre-existing heart or lung disease, morbid obesity, or bleeding tendencies may not be the best candidates for robotic prostatectomy. Fortunately, focal therapy or radiation therapy can serve as alternative or additional treatment options.
Patients with known metastatic disease are not candidates for robotic prostatectomy. Patients with recurrent prostate cancer may not be candidates. Although patients with very large prostate glands can undergo robotic prostatectomy, operative times are generally longer than in patients with smaller prostate gland sizes.
Dr. Jeannie Su is a fellowship trained urologist specializing in robotic prostatectomy. With her expertise and skill, Dr. Su is able to remove the prostate gland with precision and accuracy, while minimizing damage to surrounding tissues including the nerves that affect erections and muscles affecting continence. Patients who undergo robotic prostatectomy with Dr. Su can expect a quicker recovery time, less pain, and reduced scarring compared to traditional open surgery.