Robotic Prostate Surgery and Robotic Prostatectomy

November 3, 2015

Prostate cancer is a scary diagnosis for any family, but it’s important to remember that prostate cancer, if detected early, can be effectively treated and even cured. The AUA (American Urological Association) recommends that men between the ages of 55-75 be screened on a yearly basis with a PSA blood test and rectal prostate exam. Men with a family history of prostate cancer or of African-American descent should be screened at an earlier age (starting around 45 years old). If the blood test or exams indicate suspicious findings, a prostate biopsy may be recommended. Biopsy is the standard tool of diagnosing prostate cancer.

If you have been diagnosed with prostate cancer, there are different treatment options available depending on your type of cancer and other factors such as health, age, and life expectancy. This includes surgical removal of the prostate, radiation, hormonal treatment, and for some, surveillance. Patients may also have a combination of treatments. In many cases surgery is recommend as the best option for cure.

Dr. Koushik and Austin Urology Institute have been at the forefront of robotic prostate cancer treatment in Texas. Dr. Shaw is a daVinci Robotics expert and one of the few physicians in the world who trains other doctors on how to perform daVinci robotic surgery.

daVinci robotic prostatectomy is one of the newest treatment options available for prostate cancer treatment. The daVinci Robotics system is entirely operated and controlled by Dr. Shaw from about 10 feet away. This is a minimally invasive surgery with small incisions. It allows for faster recovery time, less pain, less blood loss, and more precision compared to the traditional open surgery. Robotic prostatectomy is an inpatient procedure, completed in about three hours and requires an overnight stay in the hospital. The operation is performed under general anesthesia, so you’ll be asleep through the whole surgery.

The fine movements of the robotic arms allow the surgery to be performed with extreme precision. The prostate is removed, along with nearby structures called the seminal vesicles. We do our best to preserve nerves around the prostate; however how successful we are depends on the extent and location of the cancer. The urethra is then re-anastomosed to the bladder, and the incisions are closed. The prostate and seminal vesicles are sent to pathology to be analyzed, and we review that report with you at your follow up visit. During the surgery, the entire prostate is removed along with the seminal vesicles and a portion of the vas deferens.

Most of our patients do quite well after surgery. Pain is usually minimal by the time you’re home, decreasing the need for pain medication. Although the incidence of operative complications with radical prostatectomy is quite low, the primary postoperative side effects are urinary incontinence and erectile dysfunction. The majority of patients will have 98% resolution of their urinary leakage by about 3 months. There are a variety of treatment options available for erectile dysfunction for men who have undergone prostatectomy. The nerves that are separated from the prostate during surgery play a crucial role in erectile function. Although there is a component of time and patience to regain normal erectile function, we work very closely with our patients to ensure they are satisfied.