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Robotic Operation For Prostate Cancer

Smart Surgery Advanced Robotic Prostatectomy For Prostate Cancer

Robotic surgery for prostate cancer

SMART Prostate Surgery

SMART is a revolutionary and advanced prostate cancer surgery and prostate cancer treatment method, which drastically reduces blood loss, pain, hospital stay, recovery time, and the side effects of other types of prostate cancer treatments. The SMART Technique is also known as bloodless prostate surgery. The SMART Technique does not require opening the endopelvic fascia or cutting the dorsal vein complex. This results in no sutures and less damage to the neurovascular bundle.

Dr. Samadi is able to enter into the patient through a few small keyhole entrances and handle the SMART robotic surgery with very tiny and precise instruments that allow him to perform the surgery with great precision and remove the patients prostate gland without doing any harm to surrounding tissue. The patient is left with only a few small marks on his abdomen none of the scars normally associated with prostate cancer treatment and surgery.

Who Should Undergo Radical Prostatectomy

Men younger than age 75 with limited prostate cancer who are expected to live at least 10 more years tend to get the most benefit from radical prostatectomy.

Before performing radical prostatectomy, doctors first try to establish that the prostate cancer has not spread beyond the prostate. The statistical risk of spread can be determined from tables comparing the results of a biopsy and PSA levels. Further testing for spread, if needed, can include CT scans, bone scans, MRI scans, and ultrasound.

If it appears that the prostate cancer has not spread, a surgeon may first offer other options besides surgery. These can include radiation therapy, hormone therapy, or simply observing the prostate cancer over time, since many prostate cancers grow slowly. Depending on how high the risk of cancer spread, pelvic lymph node dissection may be considered, as well.

Prostate Cancer Treatment Da Vinci Robot Assisted Prostatectomy

Overview by Mr Declan Cahill, Consultant Urologist, The Royal Marsden NHS Foundation Trust

da Vinci prostatectomy video for patients

Prostate Cancer Treatment Robotic Assisted Prostatectomy

Radical prostatectomy is one of the longest running treatments for prostate cancer. It has evolved over the years from open surgery, into laparoscopic , and currently robotic-assisted laparoscopic . In terms of cancer control it has been shown to have the best outcomes from all the available treatment options, as there are studies with nearly 20 years of follow-up showing the effectiveness of the technique. This is because prostate cancer cannot come back if it is physically removed completely. If radical prostatectomy does not remove everything as intended that will be witnessed by a detectable PSA and addressed. Other techniques that preserve the prostate sometimes fail because the cancer persists despite the treatment delivered or its presence elsewhere masked by the presence of the prostate.

Prostate cancer treatment using the Da Vinci robot

The robotic method has revolutionized radical prostatectomy, as it has led to a significant reduction in blood loss and reduced the length of hospital stay for the patient over open surgery, whilst giving the surgeon a precision of movement not previously possible by either the open or laparoscopic techniques.

There are multiple advantages of surgery over other techniques:

Outcomes for Robotic Assisted Prostatectomy

Recommended Reading: Things To Do To Prevent Prostate Cancer

* Minimal Blood Loss With Da Vinci Robotic

The average estimated blood loss per patient averages 116 cc. This volume is roughly the 1/3 of the volume of a 12 oz. soda can. Estimated Blood loss has ranged for robotic patients from 25cc to a maximum of 400 cc in the 1st 100 patients. Because of these low blood losses, none of these men required a blood transfusion, nor were they asked to donate autologous blood prior to surgery.

Robotic Surgery Technology Helps Difficult Prostate Cancer Operation At Henry Ford

Actual demo of robotic surgery for prostate cancer

Prostrate surgery with robot can help even the most difficult cases

An avid scuba diver’s scar tissue around his prostrate got a helping hand from a surgical robot at Henry Ford.

FOX 2 – Donnel Hollister loves to scuba dive, but when prostate screenings identified high PSA levels, he began to wonder if his adventure-seeking days would be sidelined. He was diagnosed with prostate cancer.

“I was thinking the worst, ok, – am I going to die,” he said.

Doctors performed surgery to remove the prostate but during the procedure encountered a roadblock of scar tissue, left behind from one of Hollisters previous surgeries. In most cases like this, doctors are unable to remove the cancer through surgery and they have to rely on radiation.

But thanks to a newer surgical robot used by Henry Ford Hospitals urology team, Dr. Wooju Jeong could still offer Hollister a surgical option for prostate cancer treatment despite the scarred tissue. The robot allowed the doctor another avenue to reach the prostate

“I decided to go through the bladder,” said Dr. Wooju Jeong. “Were going to make a small incision, we can get in there and we can do a procedure with multiple arms.

“Because of this technology we are able to reach the prostate gland through the bladder gently and get the surgery done.”

Hollister had his surgery just last month and his recovery is going well.

Also Check: What Age To Get Checked For Prostate Cancer

What Are The Benefits To Patients Who Have Laparoscopic And Robotic Prostate Cancer Surgery

The benefits are similar between robotic and laparoscopic prostate surgery. Patients are usually able to go home the day after prostate surgery, and can return to daily living activities as early as 7-10 days after surgery. Patients undergoing open surgery generally have 4-6 weeks before they can resume routine daily living activities, generally experience less post-operative pain and discomfort and have a faster recovery. They also experience significantly less intraoperative bleeding. Robotic and laparoscopic prostatectomy uses small incisions and is highly precise the risk of incontinence is low and the surgical technique is continuously refined to improve potency.

One Week After Surgery

After one week to ten days, your catheter will generally be removed by a urology nurse in the hospital. You will also meet Dr Arianayagam to go through the pathology results and discuss any extra treatments if needed. Pelvic floor physio therapy is restarted at this point and we also commence PDE5 inhibitors and penile vacuum devices as well to aid in recovery of erectile function. You should be active but still focus on your recovery as your body will still need to heal.

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External Beam Radiation For Prostate Cancer

When most patients think of radiation therapy, they think of external beam radiation therapy , in which a beam of radiation is directed at cancerous tissue from outside the body. Technological advances, such as intensity-modulated radiation therapy and image-guided radiation therapy , allow radiation oncologists to use computer-controlled devices and image-guidance technology to see and target a three-dimensional image of the tumor, making the treatment more precise than ever before.

EBRT used to require 40-45 daily treatments. Now, 25-28 treatments are the norm. This type of protracted, fractionated radiation therapy, however, is now generally considered to be less appropriate for low-risk and favorable intermediate-risk patients. Instead, hypofractionated techniques and brachytherapy techniques are generally more advisable for many patients.

Side Effects Of Prostate Surgery

Robotic surgery for prostate cancer at OHSU

The major possible side effects of radical prostatectomy are urinary incontinence and erectile dysfunction . These side effects can also occur with other forms of prostate cancer treatment.

Urinary incontinence: You may not be able to control your urine or you may have leakage or dribbling. Being incontinent can affect you not only physically but emotionally and socially as well. These are the major types of incontinence:

  • Men with stress incontinence might leak urine when they cough, laugh, sneeze, or exercise. Stress incontinence is the most common type after prostate surgery. It’s usually caused by problems with the valve that keeps urine in the bladder . Prostate cancer treatments can damage this valve or the nerves that keep the valve working.
  • Men with overflow incontinence have trouble emptying their bladder. They take a long time to urinate and have a dribbling stream with little force. Overflow incontinence is usually caused by blockage or narrowing of the bladder outlet by scar tissue.
  • Men with urge incontinencehave a sudden need to urinate. This happens when the bladder becomes too sensitive to stretching as it fills with urine.
  • Rarely after surgery, men lose all ability to control their urine. This is called continuous incontinence.

After surgery for prostate cancer, normal bladder control usually returns within several weeks or months. This recovery usually occurs slowly over time.

There are several options for treating erectile dysfunction:

Recommended Reading: What Is Good To Take For Prostate Health

One Month After Surgery

After a month, most men will be able to return to work, and their operation site will be near healing. Despite this, its recommended that men refrain from strenuous activity, prolonged activity, or activities that may disrupt the operation site for at least 6 weeks.

Some examples of these activities are:

Running Also, try not to sit in one position for longer than 45 minutes.

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Recommended Reading: Remedios Caseros Para El Cancer De Prostata

Performing The Robotic Prostatectomy: A Prostate Cancer Surgery General Overview For Patients

The essence of minimally invasive prostate cancer surgery is to gain access to the involved anatomy via the smallest entry points possible. Traditional open prostatectomies involved cutting open the lower abdomen with a large incision. Predictably, large incisions in traditional surgery for prostate cancer run a higher risk of infection and require significantly more time for the patient to heal, not to mention they tend to leave a large scar. Laparoscopic techniques however, using the da Vinci Robot, bypass this large incision and gain the same access through a few small holes in the skin, each roughly the size of a dime. A small plastic tube known as a “port” is inserted in each hole to keep a channel open for laparoscopic Port Placement image tools to reach through. To allow room inside for the surgeon to work, the abdomen is inflated slightly with carbon dioxide like a balloon. In this working space, the surgeon can perform the same surgeries as if the abdomen had actually been cut open, but without the large incision.

Prostatectomy: What To Expect During Surgery And Recovery

Prostate cancer surgery robot Video

If youve been diagnosed withprostate cancer, your doctor will consider many factors before recommending the besttreatment. For many men, that may mean a prostatectomy. In this surgery,doctors remove the entire prostate.

The Johns Hopkins Hospital performs more of these procedures than almostanywhere else in the world. One of the most common questions they hear frompatients: What should I expect after surgery?

Johns Hopkins urologistMohamad Allaf, M.D., explains the surgery and recovery.

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What Are The Benefits And Risks Of Robotic Radical Prostatectomy Procedure

The surgery has revolutionised the world of medical procedures, but as any other surgery, it also has a few risks associated with it.

The advantages of the Robotic Radical Prostatectomy procedure are:

  • Less pain occurs during the process because the incisions are small and almost everything is robotically controlled.
  • Fewer chances of infections because of small incisions.
  • The advantages of the Robotic Radical Prostatectomy procedure are:

    • Less pain occurs during the process because the incisions are small and almost everything is robotically controlled.
    • Fewer chances of infections because of small incisions.
    • Less blood loss and fewer complications because of more precision and accuracy, as everything is robotically controlled.
    • Shorter hospital stays for the patient and great speed of recovery.
    • Early removal of the urinary catheter.

    The major risks associated with the Robotic Radical Prostatectomy surgery are bleeding, infection, lymphocele , and inflammation in the scrotum.

    The major risks associated with the Robotic Radical Prostatectomy surgery are bleeding, infection, lymphocele , and inflammation in the scrotum.

    There are two conditions that count in the major limitations. The two conditions are leakage of urine and impotence .

    There are two conditions that count in the major limitations. The two conditions are leakage of urine and impotence .

    Open Or Laparoscopic Radical Prostatectomy

    In the more traditional approach to prostatectomy, called anopen prostatectomy, the surgeon operates through a single long skin incision to remove the prostate and nearby tissues. This type of surgery is done less often than in the past.

    In a laparoscopic prostatectomy, the surgeon makes several smaller incisions and uses special long surgical tools to remove the prostate. The surgeon either holds the tools directly, or uses a control panel to precisely move robotic arms that hold the tools. This approach to prostatectomy has become more common in recent years. If done by experienced surgeons, the laparoscopic radical prostatectomy can give results similar to the open approach.

    Read Also: What Supplements Are Good For Your Prostate

    Urinary Problems After Surgery

    Leaking urine

    Most men cant control their bladder properly when their catheter is first removed. This is because surgery can damage the muscles and nerves that control when you urinate.You might just leak a few drops if you exercise, cough or sneeze . Or you might leak more and need to wear absorbent pads, especially in the weeks after your surgery.Leaking urine usually improves with time. Most men start to see an improvement one to six months after surgery. Some men leak urine for a year or more and others never fully recover, but there are things that can help and ways you can manage it.

    Difficulty urinating

    A few men may find it difficult to urinate after surgery . This can be caused by scarring around the opening of the bladder or the urethra .Some men find they suddenly and painfully cant urinate. This is called acute urine retention and it needs treating quickly to prevent further problems. If this happens, call your doctor or nurse, or go to your nearest accident and emergency department.

    Watch Paul’s story for one man’s experience of managing urinary problems after surgery below.

    Sexual problems after surgery

    Erection problems

    Change in penis size and shape

    Changes to orgasm

    The seminal vesicles, which make some of the fluid in semen, are removed during surgery. This means you wont ejaculate any more. You may have a dry orgasm instead where you feel the sensation of orgasm but dont ejaculate. This may feel different to the orgasms youre used to.

    Risks Of Radical Prostatectomy

    Actual demo of robotic surgery for prostate cancer

    Radical prostatectomy has a low risk of serious complications. Death or serious disability caused by radical prostatectomy is extremely rare.

    Important nerves travel through the prostate on the way to the penis. Skilled surgeons can usually protect most of these nerves during radical prostatectomy. Still, complications from inadvertent nerve damage do occur after radical prostatectomy. They include:

    • Urinary incontinence: More than 95% of men younger than age 50 are continent after radical prostatectomy. Around 85% of men aged 70 or older maintain continence after the operation.
    • Erectile dysfunction : Problems with erections are common after prostatectomy. Still, most men are able to have sex after prostatectomy while using medicines for ED , an external pump, or injectable medications. The younger the man, the higher the chance of maintaining potency after prostatectomy. A period of penile rehabilitation is often necessary.

    Much of the skill involved in radical prostatectomy centers on sparing these nerves during the operation. A man undergoing radical prostatectomy by a surgeon at an advanced prostate cancer center has a better chance of maintaining sexual and urinary function.

    Other complications of radical prostatectomy include:

    • Bleeding after the operation

    Recommended Reading: Prostate Cancer Check How Often

    Surgery For Prostate Cancer

    Surgery is a common choice to try to cure prostate cancer if it is not thought to have spread outside the prostate gland.

    The main type of surgery for prostate cancer is a radical prostatectomy. In this operation, the surgeon removes the entire prostate gland plus some of the tissue around it, including the seminal vesicles.

    Why Choose The Da Vinci Robot Assisted Surgery For Your Procdure

    The da Vinci surgical system gives your surgeon an advanced set of instruments to use in performing robotic-assisted minimally invasive surgery. The term robotic often misleads people. Robots dont perform surgery. Your surgeon performs surgery with da Vinci by using instruments that he or she guides via a console. The da Vinci system translates your surgeons hand movements at the console in real time, bending and rotating the instruments while performing the procedure. The tiny wristed instruments move like a human hand, but with a greater range of motion. The da Vinci vision system also delivers highly magnified, 3D high-definition views of the surgical area. The instrument size makes it possible for surgeons to operate through one or a few small incisions.

    The da Vinci system translates your surgeons hand movements at the console in real time, bending and rotating the instruments while performing the procedure. The tiny wristed instruments move like a human hand, but with a greater range of motion. The da Vinci vision system also delivers highly magnified, 3D high-definition views of the surgical area. The instrument size makes it possible for surgeons to operate through one or a few small incisions.

    Recommended Reading: Symptoms Of Infected Prostate Gland

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