Prostate Surgery for the Overweight: How Big is Too Big?

Dear Dr. Motola:

I have been diagnosed with prostate cancer and am 51 years old. I weigh 385 lbs at 6'1". My urologist told me that at my weight he felt that surgery would be difficult because of the size of the laproscopic/robotic surgical instruments and the difficulty of the instruments being able to penetrate through my stomach and reach the prostate area.

Are there any facilities that have larger surgical instruments designed for obese patients where this surgery could be done successfully?

There are no absolute weight limits for prostate surgery, however your size does pose technical difficulties. I would suggest a consultation at a center that is known for performing robotic laparoscopic prostatectomy. They would be best able to determine if you were a candidate for the robotic approach. The length of the trocars (the devices that penetrate the abdominal wall that allow instruments to pass into the abdominal cavity) can limit the procedure. However, longer trocars that may help to facilitate the procedure are available. The real issue, however, is in the event the case needs to convert from a robotic procedure to an open procedure, the surgeon that you choose must feel comfortable operating on someone with your body habitus.