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Prostatectomy is the surgical removal of your prostate gland. During an open prostatectomy procedure, your surgeon makes a long incision in your lower belly, stands by your side, and removes your prostate through the incision. During a robotic prostatectomy, your surgeon sits at a computer console and controls tiny surgical arms. The arms are inserted through a small incision in your belly.
Robotic prostatectomy is used to treat prostate cancer. A man’s prostate gland is about the size of a walnut and it sits underneath the bladder. The main function of the prostate is to make ejaculation fluid. Prostate cancer is the most common cancer in men, but not all men need a prostatectomy.
Who Needs a Prostatectomy?
Prostate cancer is usually a slow growing cancer. If you have this type of prostate cancer, you and your doctor may decide to watch the cancer by doing blood tests, prostate exams, and prostate biopsy. In many cases, surgery is never needed.
Some prostate cancers grow quickly. These cancers can cause death if not treated. In fact, prostate cancer is the second leading cause of cancer deaths in men. Cancers that grow quickly are called aggressive. When you have a biopsy to diagnose prostate cancer, the cells will be examined and given a score for aggressiveness. This is called a Gleason score. A Gleason score less than 6 is a slow growing cancer. A score of seven is in the middle, and a score of 8 to 10 is aggressive. Prostatectomy may be the best treatment for an aggressive cancer.
What Happens During a Robotic Prostatectomy?
You will be asleep under general anesthesia. Your surgeon will make 5 keyhole incisions in your lower belly. A robotic camera will be placed through one incision, and thin surgical arms will be placed through the others. Your surgeon will sit at the control console and maneuver the camera and robotic arms.
During the procedure, the camera will give your surgeon a clear view that can be magnified up to 15 times what would be seen without magnification. Using the surgical arms, tiny blood vessels and nerves can be avoided and spared. After freeing the prostate from the surrounding tissue, it is pulled out through one of the key holes.
Benefits of Robotic Surgery Over Open Surgery
Robotic arms are steadier than any human hand. The “wrists” of a robotic arm can move in all directions and angles. These advantages along with the magnified view result in these advantages compared to traditional open prostatectomy:
- Less bleeding
- Less pain after surgery
- Time spent in hospital is as short as one or two days
- Faster recovery at home and 90% of patients return to regular activities in only two to three weeks
- Less need for narcotic pain medication
What Are the Risks of Robotic Prostatectomy?
The risks of robotic prostatectomy are about the same as with an open prostatectomy. The two biggest risks are leaking of urine and erectile dysfunction (ED). Leaking of urine – called urinary incontinence – usually occurs in the days after surgery but gradually improves. Over 95 percent of men will regain good bladder control. ED is not being able to get or keep an erection. The likelihood of ED after surgery depends on a man’s age and how sexually active he was before surgery. Most men experience only temporary ED.
What Are the Warning Signs of Prostate Cancer?
Risk factors for prostate cancer include age, family history, race, and obesity. You may be at higher risk for prostate cancer if you are over age 50, have a family history of prostate cancer, are overweight, or if you are a Black man. See your doctor if you have any of these symptoms:
- Trouble passing urine
- A weak flow of urine
- Blood in your urine or semen
- Pain in your bones
- Unintentional weight loss
To learn more about prostate health and the latest breakthroughs and procedures, see our latest report Prostate Health written by the editors at Men’s Health Advisor in cooperation with Cleveland Clinic.