Robotic Assisted
Laparoscopic Prostatectomy

What is a Robot Assisted
Laparoscopic Prostatectomy?

A prostatectomy is a surgical procedure that is performed to remove the prostate gland, seminal vesicles (glands) and a section of the vas deferens. This surgery is a treatment option for men diagnosed with prostate cancer. 

The RAPL is performed as a robot assisted surgery. A robot assisted laparoscopic prostatectomy is a minimally invasive procedure in which several small incisions are made in the patient’s abdominal region to give access to robotically controlled surgical instruments.

More details about the Robotic Prostate Surgery

Using the advanced surgical system, miniaturized robotic instruments are passed through several small keyhole incisions in the patient’s abdomen to allow the surgeon to remove the prostate and nearby tissues with great precision. This is much less invasive than a conventional radical retropubic prostatectomy, which involves an abdominal incision that extends from the belly button to the pubic bone.

During robotic-assisted radical prostatectomy, a three-dimensional endoscope and image processing equipment are used to provide a magnified view of delicate structures surrounding the prostate gland (e.g., nerves, blood vessels and muscles), allowing optimal preservation of these vital structures. The prostate is eventually removed through one of the keyhole incisions.

For most of the surgery, the surgeon is seated at a computer console and manipulates tiny wristed instruments that offer a range of motion far greater than the human wrist. The surgery is performed without the surgeon’s hands entering the patient’s body cavity.

Benefits of Robotic Surgery

Compared with traditional open surgery, patients who undergo robotic-assisted radical prostatectomy experience:

  • Less blood loss
  • Less pain
  • Shorter hospital stays
  • Faster recovery times (although catheter needs to remain in bladder for same amount of time after robotic or open procedure).

Risks of Robotic-Assisted Laparoscopic Prostatectomy

The potential risks of robotic-assisted laparoscopic radical prostatectomy include the following:

  • Bleeding
  • Infection at the surgical site
  • Adjacent tissue/organ damage

Basic pre-op preparation

  • Discontinue blood-thinning medications as outlined by the surgeon.
  • Bring containers for contact lenses or dentures to the hospital to store items during surgery.
  • Bring loose-fitting clothing to wear home after release.

Following the procedure

Following the procedure, patients will be instructed on dietary and activity guidelines, basic incision care, allowable medications, washtub restrictions, their expected recovery time, and return-to-work instructions.

Because a drainage tube may be placed in one of the incisions, and a Foley catheter is inserted to assist with urinary function, the patient will be given specific care instructions and when to follow-up with their surgeon.

FAQ's About a Robotic Prostatectomy

Q. What is robotic surgery?

A. Robotic surgery (robotic prostatectomy) is a laparoscopic approach to the treatment of prostate cancer using the da Vinci robot to assist. This device provides three-dimensional vision, magnification and an articulating robotic wrist. The robot recreates the actions performed by the surgeon at the console in a more precise manner.

Q. Can lymph nodes also be removed during the robotic procedure?

A. Yes, this depends on the stage, grade and PSA of your cancer.

Q. How long does a da Vinci robotic prostatectomy surgery take?

A. The actual procedure normally takes two to three hours, although unusual circumstances can increase the time required.

Q. Why choose a da Vinci robotic prostatectomy surgery?

A. If your doctor recommends surgery for your prostate cancer, you may be a candidate for robotic prostatectomy. This new, less-invasive surgical procedure utilizes a state-of-the-art surgical system that helps your surgeon see vital anatomical structures more clearly and to perform a more precise surgical procedure. For most patients, robotic prostatectomy offers numerous potential benefits over open prostatectomy, including:

Shorter hospital stay

Less pain and pain medication

Less blood loss and transfusions

No blood donation necessary from the patient

Less scarring

Shorter catherization

Quicker return to normal activities

Q. How long will I have to stay in the hospital after surgery, and when can I resume normal activities?

A. Most robotic prostatectomy patients are able to go home within 24 hours after surgery. Most patients are able to resume normal activities about 14 to 21 days after surgery.

Q. Will I have a urinary catheter after the surgery, and will I have normal urinary control after this procedure?

A. Yes. A urinary catheter is required to ensure adequate bladder drainage and facilitate healing of the area. Most patients experience some incontinence immediately following catheter removal, but their urinary control generally returns with time.

Q. Will I be able to resume normal sexual relations after this procedure?

A. Not immediately, although erectile function returns for most patients within nine to 12 months. Some patients are able to resume sexual intercourse within a shorter time. All patients who have a radical prostatectomy, regardless of the type of surgery used, will be sterile.