Robotic Radical Prostatectomy
Robotic Surgery for Prostate Cancer
Robotic radical prostatectomy is a minimally invasive surgical treatment for prostate cancer. The operation involves removing the prostate gland and seminal vesicles, with the aim of treating cancer that is suitable for surgical removal.
The procedure is performed through a number of small incisions using a robotic surgical system. The surgeon remains in complete control throughout the operation, using the system to operate with a magnified three-dimensional view and highly controlled surgical instruments.
Mr Neil Oakley has extensive experience in laparoscopic and robotic urological surgery, with a specialist private practice focused on robotic prostate and kidney surgery.
Patients from Sheffield and South Yorkshire can have their consultation and assessment with Mr Oakley locally in Sheffield. Where robotic prostatectomy is appropriate, surgery is undertaken in Manchester using the da Vinci robotic surgical system.
What Is a Radical Prostatectomy?
A radical prostatectomy is an operation to remove the prostate gland as a treatment for prostate cancer. The seminal vesicles, which are situated behind the prostate, are also removed as part of the procedure.
Depending on the characteristics of the cancer, lymph nodes within the pelvis may also need to be removed and examined.
Once the prostate has been removed, the bladder is reconnected to the urethra so that urine can continue to pass normally from the bladder. A urinary catheter is left temporarily in place while this join heals.
Radical prostatectomy is not appropriate for every patient diagnosed with prostate cancer. The decision to consider surgery depends on factors including the stage and grade of the cancer, investigation results, general health, age and the patient's individual treatment preferences.
Find out more about Prostate Cancer
How Does Robotic Prostatectomy Work?
Robotic-assisted radical prostatectomy is a form of minimally invasive or ‘keyhole’ surgery.
During the operation, surgical instruments and a camera are introduced through small incisions in the abdomen. The surgeon operates from a console and directly controls the robotic instruments throughout the procedure.
The da Vinci robotic system provides a magnified three-dimensional view of the surgical area and translates the surgeon's hand movements into precise movements of the instruments inside the body.
The robot does not perform the operation independently or make surgical decisions. It is a sophisticated surgical system controlled by the operating surgeon.
Why Is Robotic Surgery Used for Prostatectomy?
The prostate lies deep within the pelvis and is surrounded by important structures involved in urinary and sexual function. Robotic technology allows the surgeon to operate within this confined area using magnified vision and articulated instruments.
Compared with traditional open surgery, the robotic approach avoids the need for a large abdominal incision. As a minimally invasive technique, potential advantages can include:
- Smaller surgical incisions
- Reduced blood loss compared with open surgery
- Less post-operative discomfort for many patients
- Earlier mobilisation following surgery
- A shorter recovery period for many patients
- Detailed magnified visualisation of the prostate and surrounding anatomy
Individual outcomes vary, and the choice of surgical approach should be based on the patient's cancer, general health and individual circumstances rather than the technology alone.
Who May Be Suitable for Robotic Radical Prostatectomy?
Robotic radical prostatectomy may be considered for patients with prostate cancer where removal of the prostate offers an appropriate treatment option.
Before recommending surgery, Mr Oakley will review the available clinical information. This may include:
- PSA results and PSA history
- MRI scans
- Prostate biopsy results
- The grade and stage of the prostate cancer
- Any additional imaging or staging investigations
- General health and existing medical conditions
- Urinary and sexual function before treatment
Other treatments may also be appropriate depending on the diagnosis. A consultation provides an opportunity to discuss the role of surgery and understand its potential benefits, limitations and side effects before making a treatment decision.
Nerve-Sparing Robotic Radical Prostatectomy
Important nerves involved in erectile function run very close to either side of the prostate.
Where the position and extent of the cancer allow, it may be possible to preserve some or all of these nerves during robotic radical prostatectomy. This is known as a nerve-sparing prostatectomy.
The suitability of nerve-sparing surgery has to be assessed individually. Cancer control remains the primary objective of the operation, and preserving the nerves may not be appropriate if there is concern that cancer extends close to or beyond the edge of the prostate.
Mr Oakley has extensive experience in nerve-sparing radical prostatectomy and can discuss whether this approach may be appropriate following review of your investigations.
Find out more about Nerve-Sparing Robotic Prostatectomy
What Happens During Robotic Prostatectomy?
Robotic radical prostatectomy is performed under general anaesthetic.
The robotic camera and surgical instruments are introduced through small incisions in the abdomen. The prostate and seminal vesicles are carefully separated from the surrounding structures and removed.
Where appropriate, an attempt can be made to preserve the nerves alongside the prostate. If lymph node removal is required, this can usually be undertaken during the same operation.
After the prostate has been removed, the bladder is joined to the urethra. A urinary catheter is positioned across this join and remains in place temporarily while healing takes place.
The prostate and any other tissue removed during surgery are subsequently sent for detailed examination by a pathologist.
What Are the Possible Risks and Side Effects?
As with any major operation, robotic radical prostatectomy has potential risks and side effects. These will be discussed in detail before surgery and vary according to the individual patient.
Important considerations can include:
- Urinary incontinence following surgery
- Changes in erectile function
- Bleeding
- Infection
- Blood clots
- Narrowing or scarring where the bladder is reconnected to the urethra
- Injury to surrounding structures
- The possibility of requiring further treatment for prostate cancer
There are also risks associated with general anaesthesia and major surgery. Your individual risks and expected outcomes should be discussed as part of the decision-making and consent process.
Recovery After Robotic Radical Prostatectomy
Recovery varies from patient to patient, but the minimally invasive approach is designed to support early mobilisation and recovery following surgery.
A urinary catheter remains in place temporarily while the connection between the bladder and urethra heals. Patients are shown how to manage the catheter before leaving hospital and are advised when it can be removed.
Walking and gentle activity are encouraged as part of recovery, with activity gradually increased following the operation. Advice will be provided about driving, exercise, lifting and returning to work according to your individual recovery.
Pelvic floor exercises are also an important part of preparation and rehabilitation around prostatectomy and can help with the recovery of urinary continence.
Urinary and erectile function can take time to recover following prostate surgery, and the pattern of recovery differs considerably between patients.
Read more about Life After Robotic Prostatectomy
What Happens to the Prostate After Surgery?
The prostate removed during surgery is examined by a specialist pathologist.
This provides detailed information about the cancer, including its extent within the prostate and whether cancer cells are identified at the surgical margins. Where lymph nodes have been removed, these are also examined.
The pathology results, together with subsequent PSA blood tests, help determine the appropriate follow-up after surgery.
PSA would normally be expected to fall to a very low or undetectable level following successful removal of the prostate. PSA monitoring therefore becomes an important part of longer-term follow-up.
Robotic Prostatectomy for Patients from Sheffield and South Yorkshire
Patients considering robotic prostate cancer surgery can arrange an initial private consultation with Mr Oakley in Sheffield.
This allows your diagnosis, MRI scans, biopsy results and other relevant investigations to be reviewed locally and provides an opportunity to discuss whether radical prostatectomy may be an appropriate treatment option.
If you decide to proceed with robotic surgery, appropriate consultation and pre-operative assessment can take place in Sheffield, with the operation performed by Mr Oakley in Manchester using the da Vinci robotic surgical system.
This provides patients from Sheffield, South Yorkshire and surrounding areas with access to specialist robotic prostate surgery while allowing appropriate consultations and assessment to take place closer to home.
Private Urology Consultations in Sheffield
Find out more about Robotic Surgery for Sheffield Patients
Considering Robotic Radical Prostatectomy?
If you have been diagnosed with prostate cancer and would like to discuss robotic radical prostatectomy, you can arrange a private consultation with Mr Neil Oakley in Sheffield.