Robotic Surgery in Prostate Cancer

Robotic surgery for prostate cancer is an advanced treatment option frequently preferred in modern urology. Surgeries performed with a robotic system provide surgeons with high precision and control, aiming to remove the prostate without damaging surrounding tissues. Its advantages—such as less blood loss, shorter hospital stays, and faster recovery—make it an important approach in prostate cancer treatment.

What is Robotic Surgery in Prostate Cancer?

Robotic surgery for prostate cancer is a modern surgical method used in the treatment of prostate cancer.

The procedure is performed using the da Vinci robotic surgical system, allowing the surgeon to control the operation with high precision and accuracy through robotic arms.

This technology provides a minimally invasive approach to removing the prostate gland and helps protect surrounding tissues.

Robotic prostate surgery offers several advantages, including reduced blood loss, less postoperative pain, shorter recovery time, and lower risk of complications.

Procedures involving partial or complete removal of the prostate gland (prostatectomy) are considered part of robotic prostate surgery when performed using robotic techniques.

Robotic Surgery for Prostate Cancer

Robotic prostate surgery is a surgical method used in the treatment of prostate cancer, aiming for the complete removal of the cancerous prostate tissue.

Known in the medical literature as robotic radical prostatectomy, the procedure offers a minimally invasive approach compared to open surgery, using ports inserted into the abdominal area and robotic instruments that replicate the surgeon’s hand movements with precision.

The operation is performed under general anesthesia with the patient in a supine position. It begins with insertion of trocars into the abdomen and creation of a pneumoperitoneum.

The surgeon docks the robotic system to the patient, guided by a three-dimensional, magnified view from the console.

The bladder is mobilized downward, seminal vesicles are dissected, and the prostate’s vascular pedicles are controlled using energy devices or ligation, while periprostatic tissues are carefully dissected.

Pelvic lymph node dissection may be added according to oncological requirements, and in suitable patients, neurovascular bundles are preserved to improve functional outcomes.

Apex dissection and bladder-urethra anastomosis are completed with microsurgical precision. The removed tissue is retrieved using an endo-bag, and a catheter is placed.

Advantages of the robotic system—including 3D visualization, tremor filtering, and wristed instruments—can contribute to reduced blood loss, shorter hospital stays, and faster recovery.

Due to its minimally invasive nature, robotic prostate surgery usually does not cause severe pain. Postoperative pain can generally be managed with low to moderate doses of analgesics, offering a less painful experience compared to open radical prostatectomy.

Advantages of Robotic Surgery in Prostate Cancer

Robotic surgery for prostate cancer provides a three-dimensional, magnified view of the surgical field, allowing the surgeon to operate on tumor tissue with high precision and control.

This approach is particularly effective and considered a modern treatment option for patients with early-stage prostate cancer.

In cases where the disease is localized to the prostate gland, robotic surgery is increasingly preferred as a standard surgical approach.

Also known as robotic prostatectomy, the method is associated with less blood loss and postoperative pain, limited tissue trauma, minimal scarring, shorter hospital stays, and faster recovery.

Additionally, patients undergoing robotic surgery for prostate cancer are known to have a significantly lower risk of infection compared to open surgery.

Key Advantages of Robotic Prostate Surgery:

Provides high surgical precision with three-dimensional, magnified visualization

• Helps protect surrounding tissues
• Associated with less blood loss and reduced postoperative pain
• Causes minimal tissue damage and smaller scars
• Shorter hospital stay and faster recovery time
• Lower infection risk compared to open surgery

How Long Does Robotic Prostate Cancer Surgery Take?

Robotic prostate cancer surgery is typically completed within 2–4 hours.

The duration of the operation may vary depending on factors such as whether lymph node dissection is performed, the surgeon’s experience, the stage of the tumor, and any previous abdominal surgeries the patient may have had.

Preparations Before Robotic Prostate Surgery

Preoperative preparation is crucial to reduce complications and accelerate recovery.

Key recommendations include:

Inform the healthcare team about all prescription, over-the-counter, or herbal medications being used.

Follow fasting guidelines: no food or drink for at least 8 hours before anesthesia.

Ensure proper hygiene of the surgical area; if hair removal is necessary, use a clippers instead of a razor, and cleanse the skin with surgical-appropriate soaps.

Aim for a balanced body mass index (BMI) prior to surgery, as excess abdominal fat can complicate the procedure. Weight management and Kegel exercises are recommended.

Assess the patient’s overall health and nutrition in detail. Conditions such as obesity, hypertension, or sleep apnea should be managed beforehand to minimize surgical risks.

Postoperative Care After Robotic Prostate Surgery

Postoperative care following robotic surgery is important to reduce infection risk, promote healing, and prevent complications.

Thanks to the minimally invasive technique with small incisions, pain and bleeding are generally reduced, contributing to a more comfortable recovery. Early walking and breathing exercises help maintain lung function and reduce the risk of blood clots.

Pain medications should be taken as prescribed, and patients should avoid heavy lifting for the first 6 weeks.

Key Points to Follow After Robotic Surgery:

• Keep incision sites clean and dry
• Begin walking and breathing exercises from the first days after surgery-
• Take pain medications regularly as recommended
• Avoid heavy lifting for the first 6 weeks
• Monitor for signs of infection, such as fever, redness, or foul odor
• Do not neglect nutrition, exercise, and follow-up appointments

Frequently Asked Questions About Robotic Surgery for Prostate Cancer

Below are some commonly asked questions and answers regarding robotic surgery for prostate cancer:

Is Robotic Surgery Safe?

Robotic surgery carries a low risk of complications and is generally considered a safe option.

Is Robotic Prostate Surgery Risky?

Like any surgical procedure, robotic prostate surgery has certain risks. Your doctor will provide detailed information and guidance.

How Long Is Hospital Stay After Prostate Surgery?

Hospital stay is typically 1 to 2 days following prostate surgery.

When Is the Catheter Removed After Robotic Prostate Surgery?

The catheter is usually removed 7–10 days after robotic surgery.

How Long Does Urinary Incontinence Last After Robotic Prostate Surgery?

Urinary incontinence after robotic prostate surgery generally lasts 1–2 weeks.

How Is Sexual Function Affected After Robotic Prostate Surgery?

It is recommended to avoid sexual activity for the first 6 weeks after surgery. This allows proper healing of the surgical site, after which sexual activity can be resumed.