Robotic surgery

Robotic assisted laparoscopic radical prostatectomy is a type of keyhole surgery for prostate cancer where the instruments are held by mechanical arms controlled by a surgeon at a console.It is a minimally invasive procedure

Small incisions are made on the abdomen and this wound is enlarged at the end of the operation to remove the prostate gland. The robot is connected through ports (small straw like channels) placed through the abdominal wall to allow the surgeon to remove the prostate and nearby tissues with great precision. A 3D endoscope and image processing equipment is used to provide a magnified view of delicate structures The prostate is removed by separating it from its attachments, the pelvic muscles, bladder, rectum and erection nerves.

When you wake up from surgery you will be in the recovery ward with an oxygen mask, fluid drip into the arm, catheter in the bladder and a drain that sits in the abdominal cavity

Robotic surgery is usually the preferred treatment for men with over 10 years life expectancy with more aggressive cancer.

 

The first Da Vinci Xi machine in the Southern Hemisphere was purchased by Hollywood Hospital in 2014. They now have over 15 years experience in keyhole surgery and have performed over 1300 keyhole radical prostatectomies

Benefits

  • Less blood loss
  • Short hospital stay (one day)
  • Shorter surgery times due to the dexterity of the instruments
  • Very low transfusion rates
  • Fast recovery
  • Less pain
  • Less wound complications
  • Shorter catheter time
  • Better nerve sparing
  • Image is higher definition than laparoscopic surgery and in 3d
  • The longer instruments overcome issues of reach in patients and are wristed enabling better access to the male pelvis

Risks

  • General risks of surgery: heart attacks, strokes, pneumonia, blood clots, pulmonary embolii, blood loss and wound infections
  • Port side bleeds (1 in 200)
  • Uteric injury (1 in 1000)
  • Rectal injury (1 in 1000)
  • Incontinence- expect a significant improvement within first 6 weeks, gradual improvement over 3-6 months
  • Erectile dysfunction- expect little to no erectile function post operatively as the nerves can take up to two years to regenerate