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.
·
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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