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Shahram Shawn Gholami, M.D.

Internationally recognized expert
in Robotic Surgery

performed thousands of laparoscopic and robotic
procedures since 2000. Learn more about Dr. Gholami

 

Robotic Radical Prostatectomy for Prostate Cancer (DaVinci Prostatectomy)

Imagine major surgery performed through the smallest of incisions. Thanks to breakthrough surgical technology, doctors can now offer a minimally-invasive treatment for prostate cancer, called the DaVinci Prostatectomy.

The DaVinci Surgical System is a state-of-the-art surgical platform with 3D, high-definition vision and miniaturized, wristed surgical instruments designed to help doctors take surgery beyond the limits of the human hand. Though it is often referred to as a robot, DaVinci cannot act on its own; surgery is performed entirely by your doctor from start to finish. By overcoming the limitations of traditional open and laparoscopic surgery, the DaVinci Prostatectomy is changing the experience of prostate cancer surgery for people around the world.

What’s Involved in a DaVinci Prostatectomy?

The surgery is performed through several small incisions in the front of the abdominal wall. This allows access to the prostate which is located deep in the pelvis, below the bladder and on top of the pelvic floor. Specialized instruments are then inserted through small thin tubes and controlled by the surgeon who is sitting at a console adjacent to the operating table.

A total of six small incisions are used. At any one time, the primary surgeon has control of four instruments, including the camera. There are some subtle differences in the instruments used for robotics and standard keyhole surgery. In robotics, we use wristed instruments which facilitate a wide range of motion, thus improving access in certain circumstances.

Patients are discharged with a catheter (a small plastic tube) in place which is usually removed on day six after surgery. A dye test is then performed usually on day six or seven post surgery to confirm success before removing the catheter.

Advantages of DaVinci Robotic Surgery for Prostate Cancer

Robotic laparoscopy prostatectomy offers several advantages; following are a few of them.

Less Scarring. The first advantage to robotic surgery is that it is an application of advanced technology and is minimally invasive. Instead of having a 5-6” incision to the skin and abdominal fascia, patients have a series of small “band-aid” incisions.

A Shorter Hospital Stay. With smaller incisions, the postoperative pain is significantly less, which means your length of hospitalization is shorter – as is the time to return to usual activity. After the laparoscopic/robotic prostatectomy, patients typically do not require an inpatient hospital stay for more than one night.

Less Drugs and Blood. Patients’ need for postoperative pain medicine and narcotics is also greatly reduced after the laparoscopic/robotic approach compared to open surgery. Another advantage to robotic surgery is decreased blood loss which reduces a significant risk of the need for a transfusion.

Postoperative Catheterization. The third advantage of robotic surgery over open surgery is a reduction in the required postoperative catheterization time. After the robotic approach, the catheter typically remains in place for 5 to 7 days.

Erectile Function. The fourth advantage of robotic prostatectomy is the improved ability to preserve the erectile nerves. During an open prostatectomy – through an incision on the anterior abdominal wall – the nerves that provide erection are hidden behind the prostate. In using the surgical robot enters the abdomen and the robotic arms are positioned posterior to the prostate with the nerves directly in front of the robotic/laparoscopic camera. In this way, the nerves maybe preserved, primarily because the anatomy can be seen more clearly compared to open surgery.

Better Chance for Return of Urinary Continence. Recent studies show more patients have full return of urinary continence within 6 months as compared to patients having open surgery.

If you feel you are a candidate for a DaVinci Prostatectomy – or other emerging treatments for prostate cancer – it is important to call our office to make an appointment to discuss all of your treatment options, including the risks and benefits. Don’t hesitate – call us today!

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