Robotic Prostatectomy (Robotic Surgery for Prostate Cancer) Surgery in Mumbai, India

Robotic prostatectomy, also known as Robotic surgery for prostate cancer is a minimally invasive procedure to remove the prostate gland surgically and conserve as many healthy tissues as possible. In this procedure, incisions are made in the abdomen. This allows navigation of surgical instruments around the prostate to remove the gland without damaging surrounding blood vessels and nerves. Compared to the conventional prostatectomy procedure, the robotic prostatectomy procedure is precise, safe, and only involves small incisions that do not take long to recover.

Alternate Name of Robotic Prostate Surgery

Robotic-assisted radical laparoscopic prostatectomy (RALP) or or robot-assisted prostatectomy or Robotic Prostatectomy

Robotic Prostatectomy Procedure Type

Robotic surgery for laparoscopic prostate removal

Body Location

Prostate gland

Preparation for Robotic Prostatectomy Surgery

Certain pre-operative tests, and dietary and bowel preparations are required before surgery.

• Pre-operative tests and instructions: Before the operation - urine, blood tests, and electrocardiogram profiling has to be done. Ingesting blood thinners 7-10 days before surgery must be avoided. Vitamin supplements and herbal medications should be avoided 10 days before surgery.

• Bowel preparation: Bowel preparation, or bowel prep, is generally recommended before surgery to prevent any chances of infection. Bowel preparation is commenced 24 hours before admission to the hospital.
• Diet: Plenty of fluids are to be consumed, as bowel preparation may lead to fluid loss. Before midnight, no drinking or eating solid food is recommended.
• Banking sperm: One of the side effects of surgery is loss of erection (erectile dysfunction), as prostatectomy could lead to the removal of seminal vesicles. In such cases, sperm can be banked for the future.

How to Perform Robotic Surgery for Prostate Cancer Treatment?

Highly skilled laparoscopic surgeons perform robotic prostatectomy. During the procedure, incisions are made in the lower abdomen; parallel to the prostate gland. A sophisticated system, called Da Vinci, enables the surgeon to work with precision and control, helping him remove the enlarged prostate. A 3D endoscope and image optimization equipment are passed through the keyhole incisions. The images captured by this equipment are magnified and displayed on a monitor.

These images help the surgeon navigate tiny wristed robotic instruments around the target areas to remove the prostate gland precisely. These robotic instruments offer a wide range of motion that a human wrist finds challenging to cover. This ensures zero to a minimum amount of damage to surrounding healthy tissues, blood vessels, and nerves. It also ensured maximum preservation of healthy tissues.

The major advantages of robotic prostatectomy over conventional procedures are:

• Smaller incisions
• Maximum conservation of vital structures
• Reduced damage to healthy structures
• Shorter recovery time and hospital stay

Recovery After Robotic Prostatectomy Surgery

It normally takes three-four weeks for abdominal incisions to heal completely, so one should avoid lifting heavy objects after the operation. Some swelling can occur in the scrotum as well as the penis post-surgery, but this will get better after some time. The scrotum must not be rubbed dry but patted dry after a shower.

Daily activities such as climbing stairs and walking can be started. Heavy exercises such as cycling, jogging, and lifting weights must be avoided. One can return to work two-three weeks after the operation.

Follow-ups After Robotic Surgery for Prostate Cancer Treatment

After surgery, the patient is discharged from the hospital after 24 hours. A healthy home-cooked diet is recommended. It is recommended to not sit for more than 45 minutes or strain it too much. Post-operation wear loose-fitting clothes are recommended. Catheter removal should be done only with the assistance of medical professionals.

In case of any discomfort or pain, painkillers such as ibuprofen or Tylenol can be taken. A strong dose of a painkiller is not recommended as it might cause constipation. Oral antibiotics and other anticancer drugs are prescribed upon discharge from the hospital until the catheter is removed. Other medications that can be taken upon discharge include stool softeners to prevent any occurrence of constipation.

It is advised to refrain from swimming, hot baths, bathtubs, or any activity that involves soaking oneself in water and vigorous activities like climbing stairs, running, jumping, bicycling, etc., for at least six weeks post-surgery. However, one may resume work and driving based on recovery.

Risks of Robotic Prostatectomy Surgery

Generally, the surgery is very safe. However, some complications include:

• Bleeding: After catheter removal, slight bleeding is common.
• Blood clotting: Chances of blood clotting through robot-assisted prostatectomy are lower compared with traditional prostatectomy.
• Hernia: Hernia can occur but this happens rarely and does not cause significant harm.
• Heart attack: A rare occurrence in patients with a history of coronary heart disease.
• Impotence: Bundles of nerves on either side of the prostate might get damaged during the operation. Damage to nerves responsible for erection might lead to impotency.
• Permanent urinary incontinence: The bladder sphincter, a valve that aids in keeping urine in the bladder, might get damaged post-prostatectomy.

Frequently Asked Questions

1. What is robotic prostate surgery, and how is it performed?

Robotic prostate surgery is a minimally invasive surgical method that involves an advanced robotic surgical system. The system includes a console from which the surgeon controls and guides the robotic arms to perform complex surgeries on patients lying on the patient cart. The surgeon makes a few small incisions to insert the robotic instruments and a camera to perform the surgeries.

Robotic prostate surgeries are successful compared to traditional open surgeries due to the shorter duration of the procedure, reduced blood loss, and enhanced precision allowed by the robotic arms. The surgeon also benefits from a comprehensive 360-degree view of the surgical site, further improving the accuracy and efficacy of the surgery.

2. What are the benefits of robotic prostatectomy surgery?

Robotic prostate surgery has several benefits over traditional open surgery, including smaller incisions, reduced blood loss, less pain, shorter hospital stays, and faster recovery times. Additionally, the robotic system provides greater precision and control during surgery, resulting in better outcomes and a lower risk of complications. Being a highly precise and accurate surgical method, robotic prostate surgeries also allow preservation of urinary and sexual function, which are necessary for the overall quality of life of patients.

3. Who is eligible for robotic prostate surgery?

Robotic prostate surgery may be recommended for patients with prostate cancer or other conditions that affect the prostate gland. However, not all patients are good candidates for this procedure. The surgeon will consider a patient's overall health, age, and the stage and location of the cancer before recommending robotic prostate surgery. 

4. What is the recovery period like after robotic prostate surgery?

The recovery period after robotic prostate surgery varies depending on the patient's age, overall health, and the extent of the surgery. In general, patients may spend one or two nights in the hospital, and need to limit their physical activity, like heavy lifting or driving, for extended hours, for several weeks after surgery.

5. How can I find a skilled surgeon for robotic prostatectomy surgery in Mumbai?

To find a skilled surgeon for robotic prostatectomy surgery in Mumbai, you can start by researching hospitals and clinics that offer this procedure. Look for facilities with high patient volumes and experienced surgeons with successful surgical outcomes. One can also check the surgeon's credentials, global training records and board certifications. Additionally, always consult with your general physician or urologist. At Nanavati Max Hospital, you can select a specialist of your choice at the hospital, at www.nanavatimaxhospital.org or by booking an appointment via the Max My Health app.