What is the treatment of choice when prostate cancer is diagnosed?
Robotic radical prostatectomy (RRP) is today the treatment of choice for prostate cancer with curative intent, as recommended by the International Societies of Urology. The treatment is based on removing the prostate, part of the surrounding tissue and the seminal vesicles. It is a complex surgery and requires a high level of technical precision to minimize the risk of sequelae if the best results are to be obtained.
The prostate is surrounded by nerves and structures that are important for the patient to be able to have a normal urinary and sexual function, which we try to preserve as much as possible without compromising the oncologic result of the surgery.
The quality of surgery is essential to achieve satisfactory results in both cancer control and to avoid sequelae that can significantly and permanently affect patients’ quality of life. Precision is the most important factor in obtaining the best results. Precision is determined by the surgeon’s experience and the tools necessary to be able to perform it, with the da Vinci Xi robot currently being the latest technology available for performing this type of surgery.
How does the surgeon’s experience influence the success of the surgery?
One of the most important aspects is the surgeon’s experience in handling the da Vinci robot. This experience is possibly one of the most relevant and most influential in the success of the surgery, as well as in the reduction of complications and possible postoperative sequelae.
For this reason, it is essential that the surgeon has as much experience as possible in the management of robotic surgery. At Suturo, we have extensive experience in the management and use of robotic prostate surgery.
What are the advantages of robotic surgery for the treatment of prostate cancer?
Robotic surgery brings great and important benefits to patients, its advantages are unquestionable, allowing us a 3D vision and magnified x 10 allowing greater precision throughout the surgery and thus appreciate in greater detail all tissues. It is as if we were inside the organism with all the advantages of minimal invasion.
The tools and instruments used have a rotation of more than 360 degrees, so the surgeon has a great freedom of movement -surpassing that of the human hand- which increases the possibilities of suturing and dissection during surgery. At the same time, they are very small, so the precision of each cut increases, allowing the surgeon to go slowly and step by step, reducing the aggression to healthy tissues and preserving all the desired structures, performing microsurgery and going nerve by nerve and vessel by vessel. Thanks to this, the side effects of prostatectomy are significantly reduced, increasing the possibilities of sexual potency and postoperative urinary continence.
At the same time, since there are no tremors -as opposed to laparoscopy, for example- the image is static, offering an exact quality of vision, thus increasing the surgeon’s ability to concentrate.
These advantages provided by robotic surgery are very important, since they are beneficial for patients undergoing surgery for prostate cancer. Mainly, there are two factors: minimal aggression on the organism and maximum precision when removing the prostate.
Is surgery indicated for all patients with prostate cancer?
When prostate cancer is diagnosed, surgery can be performed as long as the cancer is inside the prostate. In expert hands, surgery can be considered even in more advanced and high-risk tumors. These patients must be evaluated individually since the possibility of surgery depends on many factors such as the type of tumor, its extension, the patient’s age,…
Robotic surgery together with the surgeon’s experience significantly reduces the possible complications of surgery.
What are the contraindications for surgery if prostate cancer is diagnosed?
There is no absolute contraindication for not performing a prostatectomy and whether or not to perform the operation will depend on several factors that must be evaluated according to each patient.
What do we expect when we operate on a radical prostatectomy patient? What are the results of the surgery?
The ideal result would be one that achieves five objectives: avoidance of tumor recurrence, urinary continence, preservation of sexual potency, negative surgical margins and absence of complications.
Robotic surgery currently represents the option most likely to achieve all five objectives, given its precision and all the advantages it brings to the patient.
What are the complications of robotic surgery?
Robotic radical prostatectomy is a very safe technique in expert hands. Complications are very infrequent, provided that the urologist who performs the operation has ample experience in the handling of robotic surgery.
What care should the patient follow after the operation?
The patient is admitted the same day of surgery and in most cases the postoperative period is uneventful and the patient can be discharged with bladder catheter in approximately 48 hours, being asymptomatic and not needing special postoperative care.
The bladder catheter will normally be removed ten days after the operation. If you would like more information about radical prostatectomy, please consult a specialist in Urology.