There are many options to treat prostate cancer that has not spread to other organs in the body. These options include radical surgery, seed implantation, external beam radiation, hormonal therapy, cryosurgery and watchful waiting. There are four surgical options to treat prostate cancer: 1) radical retropubic prostatectomy, 2) radical perineal prostatectomy, 3) laparoscopic prostatectomy and 4) robot-assisted laparoscopic prostatectomy. The goal of these procedures is to remove the prostate gland so the cancer can be eradicated.
Robotic-assisted surgery is quickly becoming the gold standard to remove the prostate gland. How does robotic surgery work? Does the surgeon press a button and the robot performs the surgery for the doctor?
Robot-assisted surgery is an extension of laparoscopic surgery (key-hole surgery). A surgeon begins by placing laparoscopic ports into the patient's abdominal cavity. It's like arthroscopic surgery (joint surgery with cameras) but in the abdomen and pelvis. Robotic arms are connected and "docked" to these ports. The surgeon then sits at a console to control the robot. The console consists of a three-dimensional monitor and joysticks to drive the robotic arms. These robotic arms house specialized surgical instruments such as forceps, scissors, and the camera to see inside in the patient's body.
The surgeon uses the joysticks to tell the robotic arms what to do. This is similar to a video game. If you move the right arm up, the right-sided instrument inside the patient moves up. If you pinch your fingers together, the scissors will cut. The robotic arms follow every motion directed by the surgeon. Coordinated by a computer program, these movements are smooth, without tremor and precise. Essentially, they mimic the human hand. In addition, the camera used to see inside the body is magnified and allows the surgeon to see the smallest of body parts up-close.
These technological advances allow the urologist to perform a better prostatectomy. The advantages to robotic surgery are as follows: 1) smaller incisions are required, 2) less blood loss, 3) better nerve control to prevent impotency, 4) less pain, 5) quicker return of urinary control and 6) quicker return to normal daily functions.
Urologists are seeing a steady trend toward robotic surgery for prostate cancer. This procedure is revolutionizing how we treat men with prostate cancer. I am going to spend the next few weeks reviewing and detailing robotic surgery for prostate cancer. These topics will include proper patient selection, urinary control and erectile dysfunction after surgery, the recovery process and what to expect after surgery.
Published On: September 24, 2007