da Vinci Robotic Surgery for Prostate Cancer in India - Best Cancer Hospital India

da Vinci Robotic Surgery for ProstateCancer

Robotic laparoscopy prostatectomy offers several advantages. Although experts do not agree as to whether robotic or open surgery is best, the majority of prostate cancer surgeries in the U.S. are being done with the laparoscopic/robotic approach, particularly at high volume medical centers that specialize in prostate cancer treatment. The post-operative goals for treating prostate cancer are the same regardless of whether the operation is done with an open or laparoscopic approach.

Less Scaring

The first advantage to robotic surgery is that it is an application of advance technology and is minimally invasive. Instead of having a 5 or 6” incision to the skin and abdominal fascia (See image below, left), 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 over one night. Surgery is done in the morning and they typically go home after lunch on the first operative day.  Comparitively, after the open prostatectomy patients spend at least two nights in the hospital primarily for pain control, nausea and difficulty getting out of bed and getting back to an activity level that would be appropriate for them to be discharged home. .

Postoperative Catheterization

The third advantage of robotic surgery over open surgery is a reduction in the required postoperative catheterization time. After open surgery, foley catheters are left to drain the urine for usually two or more weeks. After the robotic approach, the catheter typically remains in place 5 to 7 days. The reason for this difference is unclear but may be related to the increased precision and visibility the robotic approach offers and also maybe that a running anastamosis (bringing the bladder neck and urethral sphincter back together) may be done in a water-tight fashion compared to the open approach.

Erectile Function

The fourth advantage of robotic prostatectomy is the (at least theoretical) 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. The approach taken 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.

Advantages of Roboticprostatectomy

·         Minimal Bleeding  Faster return to normal daily activities .

·         Reduced hospital stay Significantly less pain and scarring

·         Lower blood transfusion rates

·         Improved preservation of physical appearance.

·         Three (3) D vision enables surgeon to perform Prostate excision with Cancer.

·         Control without risk of Post Surgery Continence (control over urinary and fecal discharge) and causing Impotency

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Laser Treatment for Enlarged Prostate (BPH) - Prostate Surgery in India

Diagnosis for Enlarged Prostate (BPH)

Clinical symptoms and physical examination provide the basis for diagnosis of Enlarged Prostate or Benign Prostatic Hyperplasia. The physical examination includes a digital rectal examination (DRE).

Digital Rectal Examination (DRE) 

DRE typically takes less than a minute to perform. The doctor inserts a lubricated, gloved finger into the patient's rectum to feel the surface of the prostate gland through the rectal wall to assess its size, shape and consistency. Healthy prostate tissue is soft, like the fleshy tissue of the hand where the thumb joins the palm. Malignant tissue is firm, hard and often asymmetrical or stony like the bridge of the nose. If the examination reveals the presence of unhealthy tissue, additional tests are performed to determine the nature of the abnormality.

PSA Test

Blood test to check the levels of prostate specific antigen (PSA) in a patient who may have BPH helps the doctor to eliminate the diagnosis of prostate cancer. 

Uroflowmetry Test 

This is a simple test which records the urine flow to determine how quickly and completely the bladder can be emptied. With a full bladder, the patient urinates into a device that measures the amount of urine, the time taken, and the rate of urine flow. Patients with stress or urge incontinence usually have a normal or increased urinary flow rate, unless there is an obstruction in the urinary tract. A reduced flow rate may indicate BPH. 

Post-Void Residual (PVR) 

This test measures the amount of urine that remains in the bladder even after urination. The patient is asked to urinate immediately prior to the test and the residual urine is determined by ultrasound. PVR less than 50 ml. generally indicates adequate bladder emptying and measurements of 100 to 200 ml or higher often indicates blockage.

Laser Treatment for Enlarged Prostate (BPH)

Holmium Laser Enucleation of the Prostate (HoLEP)

Holmium Laser Enucleation of the prostate (HoLEP) is a modern alternative to the standard Transurethral Resection of the Prostate (TURP) procedure for bladder outflow obstruction due to BPH. It requires a short period of hospitalisation and an anaesthetic.  A catheter (a tube which drains the bladder) is also needed for 1-2 days until the urine clears. Patients are advised to take life quietly and to avoid straining or heavy lifting for four weeks after the surgery.

Holmium Laser Enucleation of the prostate (HoLEP) is a modern alternative to the standard Transurethral Resection of the Prostate (TURP) procedure for bladder outflow obstruction due to BPH. It requires a short period of hospitalisation and an anaesthetic.  A catheter (a tube which drains the bladder) is also needed for 1-2 days until the urine clears. Patients are advised to take life quietly and to avoid straining or heavy lifting for four weeks after the surgery.

What are the advantages of HoLEP

• There is no upper size limit of prostate that can be dis-obstructed – traditionally men with prostates over 100ml in size needed major open surgery
• There is often less bleeding than after a TURP
• Discharge is often quicker than after TURP at 1-2 days
• The chance of recurrence requiring further surgery is very low
• Unlike greenlight laser operations, large quantities of prostate tissue are sent for pathological analysis
• The PSA generally drops to very low levels after HoLEP operations

Enlarged Prostate or BPH (Benign Prostatic Hyperplasia) Treatment in India

Enlarged Prostate or BPH (Benign Prostatic Hyperplasia) is a natural condition where the prostate gland slowly grows, causing pressure on the urethra, similar to a clamp on a garden hose.

Common Symptoms of enlarged prostate include:

• Frequent urination, especially at night
• Sudden need to urinate
• Difficulty beginning urination
• Pain or burning
• Feeling that your bladder never completely empties
• Dribbling or leaking
• Weak urine stream

Loss of Personal Freedom

Many men report changes to lifestyle such as avoiding travel, interruption of leisure activities and using bathroom stalls instead of urinals. Frequent trips to the bathroom can disrupt sleep.

A Simple and Effective Solution

If these symptoms are familiar to you, or if you are changing your lifestyle to accommodate urinary problems, you should know that there is a simple solution. It is called GreenLight™ Laser Therapy. This therapy can free you from urinary problems without compromising lifestyle or health, giving you the green light to live life the way you want to, without compromise.

Understanding the Prostate

The prostate is a walnut-sized gland that forms part of the male reproductive system. The prostate secretes fluid that carries sperm. It surrounds the urethra, the canal which carries urine from the bladder out of the body.

With age and time, the prostate enlarges causing pressure on the urethra, similar to a clamp on a garden hose. This causes problems with urination.

Words to Know

• Prostate — A walnut-sized gland that secretes prostatic fluid which carries sperm
• Benign Prostatic Hyperplasia (BPH) — A non-cancerous enlargement of the prostate that restricts urine flow
• Incontinence — Inability to control or hold back urine
• Impotence — Failure to achieve or to maintain an erection
• Retrograde Ejaculation — When semen travels up the urethra towards the bladder instead of outside of the body
• Catheter — A thin, flexible tube inserted through the penis used to drain urine from the bladder
• Cystoscope — An instrument that allows the doctor to examine the bladder and prostate

Diagnosis

You may first notice symptoms of enlarged prostate (BPH) yourself, or your doctor may find that your prostate is enlarged during a routine checkup. When enlarged prostate (BPH) is suspected, you may be referred to a urologist, a doctor who specializes in problems of the urinary tract and the male reproductive system. Several tests help the doctor identify the problem and decide the best course of treatment. The tests vary from patient to patient, but the following are the most common.

Digital Rectal Exam (DRE)

This exam is usually the first test done. The doctor inserts a gloved finger into the rectum and feels the part of the prostate next to the rectum. This exam gives the doctor a general idea of the size and condition of the gland.

Prostate Specific Antigen (PSA) Blood Test

In order to rule out cancer as a cause of urinary symptoms, your doctor may recommend a PSA blood test. PSA, a protein produced by prostate cells, is frequently present at elevated levels in the blood of men who have prostate cancer.

Rectal Ultrasound

If there is a suspicion of prostate cancer, your doctor may recommend a test with rectal ultrasound. In this procedure, a probe inserted in the rectum directs sound waves at the prostate. The echo patterns of the sound waves form an image of the prostate gland on a display screen.

Urine Flow Study

Sometimes the doctor will ask a patient to urinate into a special device which measures how quickly the urine is flowing. A reduced flow often suggests BPH.

Intravenous Pyelogram (IVP)

IVP is an x-ray of the urinary tract. In this test, a dye is injected into a vein, and the x-ray is taken. The dye makes the urine visible on the x-ray and shows any obstruction or blockage in the urinary tract.

Cystoscopy

In this exam, the doctor inserts a small tube through the opening of the urethra in the penis. This test allows the doctor to determine the size of the gland and identify the location and degree of the obstruction.

Minimally Invasive Robotic Prostate Surgery in India

Robotic Prostate Surgery in India

Robotic Prostate Surgery - where a minimally invasive robot assisted radical prostatectomy technique eradicates prostate cancer with minimal post surgery complications

The mission of “Minimally Invasive Robotic Prostate Surgery Program” is to leverage latest technology to and treat prostate disease through small incision and great precision resulting in:

·  Shorter hospital stay, Faster recovery and return to normal activities

· Less pain and scarring , Reduced blood loss and need for blood transfusion

·  Reduction in the use of pain medicines, Decreased postoperative pain

Usually in conventional approach surgeons make decisions using tactile and visual cues to identify a phenomenon, which is actually microscopic which is likely to damage nerves or to leave some cancer behind.  Sometimes it is difficult for surgeons to find a precise plane between the cancer and urinary sphincter or the nerves and err on the side of cancer safety leading to incontinence or Impotence

Highly trained Indian surgeons who have worked for decades at some of the global centres of excellence now use Advanced Robotic technique gives surgeon a sophisticated master slave robot that seamlessly translates the surgeon's movements at the computer console into precise, real-time movements of the surgical instruments inside the patient. This ensures that the Prostate is removed excellent outcomes and minimal chances of cancer left behind after the surgery.

If you're young and in good health, the short-term risks of this surgery are low. The hospital stay is usually 2 to 3 days, with the catheter left in place for 2 to 3 weeks. You're usually able to go back to work in about 1 month. You shouldn't have severe pain with this surgery. Most men regain bladder control a few weeks to several months after the surgery.

The main advantage of surgery is that it offers the most certain treatment. That is, if all of the cancer is removed during surgery, you are probably cured. Also, the surgery provides your doctor with accurate information about how advanced your cancer is, since the nearby lymph nodes are taken out along with the tumor.

 Surgery does have risks. The main risks of radical prostatectomy are incontinence (loss of bladder control) and impotence (loss of the ability to get or keep an erection long enough to have sex). Most bladder and impotence problems improve with time.

Advanced Prostate Cancer Treatment- Best Prostate Cancer Hospital in India

Prostate Cancer Treatment in India

Prostate is a reproductive gland in males; it is relatively small organ and is located under the bladder. Prostate cancer is caused by the uncontrolled division of mutated prostate cells. These cancer cells form a tumor and obstruct the normal function of the prostate and the bladder.
It is rare in men younger than 40. Risk factors for developing prostate cancer include being over 65 years of age, family history and some genetic changes.
Symptoms of Enlarged Prostate may include:
Problems in Passing urine, such as pain, difficulty starting or stopping the stream, or dribbling.

• Low Back Pain.

• Pain with Ejaculation.

• Blood in the Urine.

• Blood in the Semen.

• Swelling in the Legs.
  

How Prostate Cancer is Diagnosed?

• Prostate-Specific Antigen (PSA) Test : A blood sample is drawn from a vein in your arm and analyzed for PSA, a substance that's naturally produced by your prostate gland. It's normal for a small amount of PSA to be in your bloodstream but if the value increases, the cause must be located.

• Ultrasound : If other tests raise concerns, your doctor may use transrectal ultrasound to further evaluate your prostate. This gives a clear picture of the prostate gland.

• Bone Scans and X-rays : It may reveal whether the cancer has invaded the bones. To perform a bone scan, doctors inject low doses of a radioactive substance into the patient's vein, which accumulates in bones that have been damaged by cancer.

• Digital Rectal Exam (DRE): During a DRE, your doctor inserts a gloved, lubricated finger into your rectum to examine your prostate, which is adjacent to the rectum. It helps to detect any structural anomalies in the prostate.

• Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) Scans : They can further pinpoint the location of cancer that has spread beyond the prostate.

• Biopsy : The removal of cells or tissues so they can be viewed under a microscope by a pathologist. The pathologist will check the biopsy sample to see if there are cancer cells and find out the Gleason score.

Most Advanced Technology for Prostate Cancer Treatment - Low Cost Prostate Cancer Treatment in India
Treatment of Prostate CancerThe treatment of prostate cancer depends on several factors such as

• Stage at which cancer was detected and diagnosed

• The age of the patient

• The health of the patient

• Whether the cancer is a recurrence

• Speed with which the cancer is growing

Laser Surgery for Enlarged Prostate Cancer

• Green Light Laser PVP : Photoselective Vaporization of the Prostate (PVP), also known as the Green Light Laser, has emerged as the treatment of choice for most patients having surgery for BPH. It is minimally invasive in the sense that all the work to open the prostate channel is made through the penis, without an incision on the abdomen. 

• The obstructive prostate tissue is vaporized by the directed laser beam. This is done under spinal or general anesthesia. The advantages of this approach over the traditional TURP (transurethral resection of the prostate) are many :

• Rapid urine flow improvement.

• Quick return to normal activities.

• Virtually bloodless procedure.

• Outpatient procedure in otherwise healthy patients.

Surgical Treatment for Prostate Cancer

• Radical Prostatectomy Surgery : Radical prostatectomy surgery aims to remove the whole prostate gland and the nearby lymph nodes. After the prostate gland is taken out through an incision, a catheter (a narrow rubber tube) is put in the bladder to carry urine out of the body until the area heals.

• Laparoscopic Radical Prostatectomy : The surgeon deploys a Laproscope a thin tube with a tiny camera . Its a minimally invasive procedure where small cuts are made near the tumor site, and thin tools are used to remove the tumor and surrounding tissue. Usually patient are given general anaesthesia or an epidural or spinal anaesthesia that blocks nerve routes from the spine and numbs the area. If the cancer spreads outside the esophagus, it often goes to the lymph nodes first. (Lymph nodes are small, bean-shaped structures that are part of the body's immune system.) Esophageal cancer can also spread to almost any other part of the body, including the liver, lungs, brain, and bones.

• External Beam Radiotherapy : This is a treatment where high-energy X-rays are aimed at a cancer to cure or control it. The X-rays come from a machine called a linear accelerator. This is known as external beam radiotherapy.

• Radiotherapy : Radiotherapy uses high energy waves to treat cancer. If your cancer has not spread beyond the prostate gland you can have radiotherapy to try to cure it. This is called radical radiotherapy. This type of treatment involves giving a high dose of radiation to the prostate gland.

• Hormone therapy : Cancer of the prostate depends on the male hormone testosterone for its growth. By reducing the amount of testosterone in your body, the growth of cancer cells can be slowed down or stopped. It can shrink the tumour and urinary symptoms can often disappear fully.

• Chemotherapy : Chemotherapy is the use of drugs to cure or control cancer. Chemotherapy may be used if your cancer has spread beyond the prostate and is no longer controlled by hormone therapy. In some cases, chemotherapy will improve your quality of life with better control of your symptoms. 

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Options for Prostate Cancer Treatment and Surgery in India

Prostate Cancer Treatment and Surgery in India

High Intensity Focused Ultrasound (HIFU) - It makes use of high frequency energy to heat and destroy cancer cells in the prostate gland.When these sound waves are concentrated on body tissues, the tissues heat up and die. Specialists target the area containing the cancer.It is an outpatient procedure generally performed under local or general anesthesia. As HIFU is non surgical, there is no incisions or blood loss and recovery is quick.

Robotic Surgery - Robotic surgery for prostate cancer removal is an advanced technique whereby the robotic arms hold the surgery tools. The advantages of this surgery type are very high precision in performing the surgery and reducing the risks associated with the surgery.

Cyber Knife Treatment - In this procedure, the patient lays still and breathes normally while the CyberKnife zeroes in on the prostate and irradiates it without harming surrounding areas. The procedure is more comfortable for patients, as radiation is given accurately and treatments are completed in four to five days.

Laser Surgery - This procedure has emerged as the top choice for most patients. It is minimally invasive as all work to open the prostate channel made through the penis, is done without an incision on the abdomen. This surgery helps patients urinate better and with a good stream. The patient is able to empty his bladder fully after the surgery.In Laser Surgery for Prostate cancer, the obstructive prostate tissue is vaporized by the directed laser beam.

Radical Prostatectomy - It is the surgery done to remove the entire prostate and any nearby tissues like seminal vesicles and some nearby lymph nodes. Radical prostatectomy can be done as either open or laparoscopic surgery. The surgeon removes the prostate through a cut in the abdomen, or makes a series of small cuts instead of one larger cut. Sometimes prostate is removed through a cut in the area between the testicles and the back passage.After the prostate gland is taken out through an incision, a catheter is placed in the bladder to pass urine out of the body until the area heals.

Laparoscopic Radical Prostatectomy - A thin tube with a tiny camera is deployed. Small cuts are made near the tumor site, and thin tools remove the tumor and surrounding tissue. Patients are usually given general anesthesia that blocks nerve routes from the spine and numbs the area.

External beam Radiotherapy - This treatment deploys high radiation dose just on the area of the prostate gland. The whole of your prostate gland is treated along with an area of 1 to 2 centimetres around it.

Brachytherapy - Brachytherapy makes use of high dose of radiation reducing the risk of damage to nearby healthy tissue while destroying the tumor. Doctors place Brachytherapy seeds inside a body cavity or insert seeds into body tissue using hollow needles. It may be used alone or with radiation given externally. Radioactive seeds may be left permanently in place or removed after some time.

Hormone Therapy - Hormones occur naturally in your body and control the growth and activity of normal cells. Prostate gland cancer depends on the male hormone testosterone to grow. Lowering the amount of testosterone in the body can reduce the chance of an early prostate cancer coming back after treatment.

Chemotherapy - Chemotherapy involves drugs to kill cancer cells. It is used to treat prostate cancer that has spread to other parts of the body and is used mainly if hormone therapy is not controlling the cancer.

Cryotherapy - Cryotherapy uses an instrument to freeze and destroy abnormal tissue. Cryosurgery can be used to treat men who have early-stage prostate cancer that is confined to the prostate gland. It is less well established than standard prostatectomy and various types of radiation therapy. Long-term outcomes are not known. Because it is effective only in small areas, cryosurgery is not used to treat prostate cancer that has spread outside the gland, or to distant parts of the body.

Laser and Robotic Prostate Surgery in India

Robotic Prostate Surgery Service - where a minimally invasive robot assisted radical prostatectomy technique eradicates prostate cancer with minimal post surgery complications

The mission of “Minimally Invasive Robotic Prostate Surgery Program” is to leverage latest technology to and treat prostate disease through small incision and great precision resulting in:

·  Shorter hospital stay, Faster recovery and return to normal activities

· Less pain and scarring , Reduced blood loss and need for blood transfusion

·  Reduction in the use of pain medicines, Decreased postoperative pain

Usually in conventional approach surgeons make decisions using tactile and visual cues to identify a phenomenon, which is actually microscopic which is likely to damage nerves or to leave some cancer behind.  Sometimes it is difficult for surgeons to find a precise plane between the cancer and urinary sphincter or the nerves and err on the side of cancer safety leading to incontinence or Impotence

Highly trained Indian surgeons who have worked for decades at some of the global centres of excellence now use Advanced Robotic technique gives surgeon a sophisticated master slave robot that seamlessly translates the surgeon's movements at the computer console into precise, real-time movements of the surgical instruments inside the patient. This ensures that the Prostate is removed excellent outcomes and minimal chances of cancer left behind after the surgery.

If you're young and in good health, the short-term risks of this surgery are low. The hospital stay is usually 2 to 3 days, with the catheter left in place for 2 to 3 weeks. You're usually able to go back to work in about 1 month. You shouldn't have severe pain with this surgery. Most men regain bladder control a few weeks to several months after the surgery.

The main advantage of surgery is that it offers the most certain treatment. That is, if all of the cancer is removed during surgery, you are probably cured. Also, the surgery provides your doctor with accurate information about how advanced your cancer is, since the nearby lymph nodes are taken out along with the tumor.

Surgery does have risks. The main risks of radical prostatectomy are incontinence (loss of bladder control) and impotence (loss of the ability to get or keep an erection long enough to have sex). Most bladder and impotence problems improve with time.

About MyMedOpinion.com

MyMedOpinion affiliated  Best hospitals in India provide an medical opinion from experienced surgeons and the treatment cost includes companion stay  , surgeon fee, medicines and consumables, nursing care, patient's food and airport pick up & drop etc. etc. We offer free, no obligation assistance to international patients to find world class medical treatment in India. We offer support and services to facilitate the care you require. We can help you find the best hospital in India

Send us a Medical Report to Get FREE Medical Opinion from India's Top Doctors

MyMedOpinion.com  is the hub of Surgeons and specialists for major diseases. We give you a chance to speak to our doctors and discuss your health issues directly. 

Email Us: Free@mymedopinion.com  Call Us: +91-7503537224