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FREQUENTLY ASKED QUESTIONS
- What is Prostate Cancer?
- What are some of the available surgical treatments for prostate cancer?
- What is Robotic Radical Prostatectomy?
- Am I a good candidate for a Da Vinci Robotic Prostatectomy?
- Does the Da Vinci Prostatectomy robot perform the operation?
- What if the Da Vinci Robot fails during the surgery?
- How long will I have the catheter after the surgery?
- How long does the Da Vinci Robotic Prostatectomy take?
- What is a laparoscopic radical prostatectomy?
- What is radical retropubic prostatectomy?
- What are some of the advantages of laparoscopic radical prostatectomy?
- How does a laparoscopic radical prostatectomy compare to open as far as the cancer cure rate?
- How long does the procedure take?
- How long do I stay in the hospital?
- How long do I need to have a catheter after the laparoscopic radical prostatectomy?
- What is the blood loss for this procedure?
- Are the nerves responsible for sexual function being spared during this procedure?
- Am I going to leak after a laparoscopic radical prostatectomy?
1. What is Prostate Cancer?
The Prostate is a walnut sized gland located above the rectum, attached to the bladder and urethra. It’s main purpose is to produce fluid that transports sperm during the male orgasm. According to recent estimates, there are 180,000 to 200,000 newly diagnosed cases of prostate cancer detected annually. Prostate Cancer is the second leading cause of cancer death in men after Lung Cancer. Close to 40,000 men die as the result of Prostate Cancer. Prostate Cancer is characterized by the uncontrolled growth and potential spread of abnormal cells.
2. What are some of the available surgical treatments for prostate cancer?
There are three surgical options to remove the entire prostate gland. These options are for patients with early diagnosed organ confined Prostate Cancer.
1. ROBOTIC RADICAL PROSTATECTOMY
2. LAPAROSCOPIC RADICAL PROSTATECTOMY
3. TRADITIONAL OPEN RADICAL PROSTATECTOMY
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3. What is Robotic Radical Prostatectomy?
This procedure is also called Da Vinci Robotic Prostatectomy. It is a minimally invasive surgical removal of prostate which involves the latest advancements in robotics and computer technology.
It is a computer-enhanced minimally invasive surgical system consisting of three component:
1. Surgeon Console
2. Surgical Cart
3. Inside Vision System
Surgeon’s Console:
The Surgeon’s Console consists of the master controls that the surgeon uses in order to manipulate the surgical cart and the EndoWrist instruments. Surgeon’s hand movements are translated to the EndoWrists through the surgeon’s Console. The instruments only move if and only if the surgeon decides to move them. The surgeon is in control of the instruments and not the robot.
Inside Vision System: This component provides a 3-D view of the surgical field which is much improved compare to a 2-D view in plain laparoscopic surgery. This translates to a much better visual field, better depth perception.
In addition there is 10-15 times magnification as the result of the cameras that is being used. Together it allows the surgeon to see the important sections of the surgery much more accurately. This is in particular important in sparing the neurovascular bundles responsible for erectile function, urethra-vesical anastomosis, visualization of prostate capsule and lowering the positive margin.
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4. Am I a good candidate for a Da Vinci Robotic Prostatectomy?
Men who are diagnosed with a localized prostate cancer are candidates for this procedure. Most patients, who are candidates for open surgery, would have an excellent outcome with this procedure. The indications for this surgery are very similar to open surgery.
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5. Does the Da Vinci Prostatectomy robot perform the operation?
Absolutely not: The robot is completely under my control. The robot allows the surgeon to operate in small spaces in the abdomen.
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6. What if the Da Vinci Robot fails during the surgery?
That is a very rare incident, once in the past three years. In that incident I was able to complete the case laparoscopically without the need to make an incision and open the patient’s abdomen. It is important to be skilled in open, laparoscopy and robotic surgery for that same reason.
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7. How long will I have the catheter after the surgery?
Catheter is removed seven days after the surgery.
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8. How long does the Da Vinci Robotic Prostatectomy take?
Typically it takes about 2.5 to 3 hours depending on the anatomy of the prostate and the body habitus.
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9. What is a laparoscopic radical prostatectomy?
Laparoscopic radical prostatectomy is a minimally invasive surgical treatment for prostate cancer. It involves a few key hole incisions in order to remove the whole prostate.
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10. What is radical retropubic prostatectomy?
Radical retropubic prostatectomy is the surgical removal of prostate, seminal vesicles and vas deferens through a lower abdominal incision. The incision measures 8 to 10 inches in length. As far as the cancer cure rate, it is essentially identical to laparoscopic radical prostatectomy.
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11. What are some of the advantages of laparoscopic radical prostatectomy?
- Shortened hospital stay (read patient testimonials)
- Significantly less bleeding
- Early removal of catheter
- Minimal requirement for pain medications after the surgery
- 10-15 times visual magnification
- Resume to normal activity within one to two weeks after operation
- Improved cosmetic results
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12. How does a laparoscopic radical prostatectomy compare to open as far as the cancer cure rate?
The results in control of cancer for the laparoscopic patients have been essentially identical to that of open radical prostatectomy. This is confirmed in major institutions across the country where this procedure is being performed on routine basis.
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13. How long does the procedure take?
It is usually about 2.5-3.5 hours. Each case is different due to the size of the prostate and different anatomy. This is comparable to the average time of open surgery.
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14. How long do I stay in the hospital?
Majority of my patients are discharged one day after the surgery. However, the time of discharge is decided on case-by-case basis. By the second night, over 90 percent of patients are comfortable to go home.
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15. How long do I need to have a catheter after the laparoscopic radical prostatectomy?
For open surgery, the catheter is removed after two to three weeks. However with laparoscopic prostatectomy, I remove the catheter seven days after the operation. This is done in our office under control of an X-ray in order to check the status of the anastomosis.
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16. What is the blood loss for this procedure?
The average blood loss for this procedure is about 150cc. Therefore, the risk of blood transfusion is extremely low. The blood vessels are collapsed due to the abdominal pressure and are well controlled as the result of a high visual magnification that is obtained with the use of a camera.
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17. Are the nerves responsible for sexual function being spared during this procedure?
Every effort is made to spare the nerves. One of the main advantages of this procedure is the fact that the nerves and vessels are all magnified and therefore it is much easier to save them. Return of potency could take up to six months and on some individual cases, Viagra has significantly helped the patients.
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18. Am I going to leak after a laparoscopic radical prostatectomy?
For the first few weeks, one needs to wear a protective pad. The return of continence is fast and within few weeks, over 95 percent of the patients have full control of their urination. Occasionally I see patients with mild stress urinary incontinence after surgery which usually resolves by performing Kegal Exercises.
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I was discharged from the hospital the day after surgery and my catheter was removed in four days. A month and a half after the surgery, I took a two week car trip to Canada by myself. Two years after the surgery I married a wonderful woman and we are living a happy life together... 
