What Is Robotic Prostate Surgery
A surgical treatment for prostate cancer, the radical prostatectomy procedure removes the entire prostate gland. Radical prostatectomy can now be done by laparoscopic or robotic techniques. In open prostate surgery, the prostate gland is removed through a larger incision in the lower abdomen. Laparoscopic prostate surgery involves key-hole incisions which used for inserting a lighted viewing instrument into the pelvic region and allows examination and removal of the prostate without a large abdominal incision.
What Is The Difference Between Robotic And Laparoscopic Radical Prostatectomy
Both are minimally-invasive techniques of performing radical prostatectomy for cancer. In laparoscopic radical prostatectomy, the surgeon stands by the operating table and himself manipulates the instruments. In robotic prostatectomy the surgeon is seated at a robotic console near the patient from where he drive the robotic instruments to perform the operation. The robot faithfully and accurately reproduces the surgeons sophisticated maneuvers.
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How Bad Is The Pain After Prostate Surgery
The level of pain is lower than that of open prostatectomy, due to smaller incisions. However, you will be administered pain medication both orally and intravenously, through an IV. Make sure you have someone to pick you up from the hospital, as you wont be able to drive right away. Ask your doctor to recommend some pain medication and dosages that you can take from home most common ones are Tylenol or Ibuprofen. Even though the recovery is fast, you should get plenty of rest and not force yourself with lifting weights or exercises in the first few weeks.
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Surgeon Console For Robotic Prostatectomy
The surgeon operates while seated comfortably at the da Vinci Surgeon Console, an ergonomically designed console viewing a 3-D image of the operative site. As the surgeon moves his hands, wrists, and fingers, the instruments are performing the same movements inside the patients body.
The da Vinci Robotic System is able to scale the doctors motions and translate them into the operating arms during robotic prostate surgery.
Prostate Surgery Recovery Timeline
Prostate surgery recovery varies from person to person depending on how their body heals naturally and how severe the condition was prior to surgery. Here are some tips to help you through your recovery.
Prostatectomy typically requires general anesthesia and a hospital stay of 1 to 4 days. Your physician will have you walk around the day of or the day after your procedure. You may also be instructed to do little exercises while you are in the bed. All prostate cancer patients will be discharged from the hospital with a urinary catheter in place. A catheter is a thin flexible tube that is usually left in your bladder for 1 to 2 weeks to help drain your urine. Your doctor will give you specific guidelines about how to care for your catheter at home. Bladder control may be difficult for a few months after the catheter is removed. Some males will need a urinary catheter for 5 to 10 days after surgery.
Refrain from driving for 1 week after your prostate surgery. Do not drive until your catheter is removed. Also, be aware that you should not drive on prescribed pain medications unless a doctor says its ok. After one week, it should be safe to resume driving and begin most daily activities.
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What Can I Eat After Prostate Surgery
Patients who have undergone prostate surgery can return to their usual dietary habits after a few days of light meals . Nonetheless, there should be integrated a few changes in order to speed up relief and pain management.
Once the surgery is over, patients are dealing with a raw surface at the level of the bladder. To avert any pain or complications, the diet at this point should be free of alcohol, spicy foods , or acidic foods
Nonetheless, in case patients consume these foods with no visible health degradations, then they can continue doing so in moderation. It is important to reach out to a dietitian and consult with specialists about the kind of dietary plans that lead to a swift recovery.
Moreover, there may linger a sense of discomfort after prostate surgery. However, in case one or several of the following symptoms relating to the digestive system occur, then patients should contact their general doctors immediately:
- Blood in the stool.
Life After Treatment: Alan Weiners Story
When Alan Weiner found out he had prostate cancer, it was a huge and frightening emotional bomb blast.
The New York native was diagnosed in February 2014 at age 69. After seeking out opinions from various doctors, Weiner underwent robotic prostatectomy in April at Mount Sinai Hospital in New York.
Because of the emotional toll his diagnosis took, Weiner says he found a support group that helped him through that uncertain time in his life. I joined Gildas Club after surgery, but if I had known about it, I would have attended sessions prior to deciding treatment, he says. I found a friend who went through the process and was understanding of my anxieties, fears, and projections.
I never thought that the emotional aspects of this would be so difficult to deal with, Weiner adds. I never believed that the mortality rate of prostate cancer was very low, and I believed that I would be the one who would not make it. I now know that my fears and negative thinking were things most men go through, however.
Today, Weiner goes for routine checkups, and two years after his initial diagnosis, his PSA level is undetectable. He deals with persistent sexual dysfunction, but the bladder control issues he first experienced after his surgery have resolved.
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Robotic Radical Prostatectomy The Standard In Prostate Cancer Treatment
Robotic prostatectomy is a radical prostatectomy that is also known as Robotic Assisted Laparoscopic Prostatectomy . It is a minimally invasive prostate removal and cancer treatment surgery.
The robotic prostatectomy system is performed with the aid of the da Vinci robot, one of the most advanced medical robots in the health industry.
This high-tech system allows the surgeon to have improved vision, control, and precise movements.
David B. Samadi, MD, is at the forefront of prostatectomy and prostate removal surgery and has performed more than 7,000+ successful procedures to date. His innovative SMART technique uses robotic prostate surgery enhancements to improve vision and precision. In Dr. Samadis skilled hands, patients are assured superior quality of life results in both sex after prostate surgery and urinary control after prostate surgery.
Wtach the video to see how is Dr. Samadi performing a robotic prostatectomy:
Recovery After Greenlight Laser Surgery
Please note that these recommendations apply to patients who undergo Greenlight Laser prostatectomy at New York Urology Specialists. Other surgeons may have different recommendations. Please contact your surgeon for instructions.
Patients can have a regular diet after the Greenlight laser of the prostate. For patients who undergo Greenlight laser prostatectomy at New York Urology Specialists, you may drink alcohol socially within reason once youre not taking medications.
You also may engage in regular nonstrenuous activities such as walking. Men should avoid sexual activity for 3-4 weeks after the Greenlight laser procedure to allow the prostate to heal. Similarly, biking and strenuous running should be avoided for 3-4 weeks after the procedure as it may provoke bleeding.
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What Is The Recovery Time After Radical Prostatectomy
You may feel tired for a few weeks after surgery. Light exercise such as walking can help with the healing process. You should avoid heavy lifting for several weeks.
You may have urinary incontinence or leakage for weeks to months after the surgery, although most people recover continence after surgery. Recovery of sexual function is expected to take months. Your doctor may start you on a medication to help with recovery of erections.
Youll need regular follow-ups with your healthcare provider to monitor for evidence of cancer recurrence and manage effects from the surgery. They can work with you to improve any problems with erectile dysfunction or bladder control.
Figure 2 Practice Makes Perfect
The likelihood that a surgeon performing laparoscopic prostatectomy will have to switch to open abdominal surgery in order to complete the operation goes down significantly with practice, measured in the number of operations performed.
Source: Journal of Urology, July 2005.
Did he mention anything about the visualization of the neurovascular bundles?
Yes, he felt pretty confident that with the increased magnification, he would be able to move them aside, and remove the prostate with no problem. He said, If the cancer has spread into the seminal vesicles, then obviously we have to deal with that. And we wont know until the operation. But he seemed pretty confident that after the operation Id be in good shape.
Did you consider having robotic surgery closer to home?
You know, I did look into it. But I did some research, and it looked like there werent many people doing this at the time in the city where I live, and they didnt have a lot of experience. One surgeon had done 50 of these operations. The doctor I met with had done about 400. So Im thinking, Okay, 50 versus 400. I think Ill go with the guy whos done 400.
What kind of logistics were necessary, with you being in one city and the operation being done in another?
There were some logistical challenges. I ended up doing the preoperative testing at a hospital near my home, and then had it sent to the surgeon in the other city. He was willing to accept their medical tests.
How long did you have it in place?
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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.
When You Might Have A Radical Prostatectomy
Your doctor might recommend a radical prostatectomy if:
- your cancer hasn’t spread outside the prostate gland. This is localised prostate cancer
- your cancer has broken through the covering of the prostate and spread to the area just outside the prostate gland. This is locally advanced prostate cancer
- you are well enough to have this operation
The aim of a radical prostatectomy operation is to cure prostate cancer.
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What To Expect After Prostate Surgery
The surgeons at AdventHealth are known for providing excellence in patient outcomes, so you can expect good results from your surgery. After surgery you should plan on:
- Spending one night in hospital. Most patients go home within 24-hours
- Being back to normal activities within 1-2 weeks
- An early return of urinary control and sexual function based on preoperative function
- A short period of catheterization
- A low complication rate
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Histology Results And Follow
You will have an appointment at 4 weeks post-operation. Between your operation and this date, your prostate will have been sent to a laboratory where it is thoroughly inspected to produce a final report on the precise details of your cancer. This is called a histology report. During this appointment you will be given the histology results, detailing the final Gleason grade and stage of tumour, which is very important in determining your prognosis and the probability of the need for additional treatment, such as radiotherapy.
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Can You Have Sex After Prostate Removal
The good news is that sex after prostate removal is very possible and enjoyable for most men. This is due to the newest robotic technologies that are nerve-sparing and preserve the sexual function.
Dr. Samadis robotic prostate surgery, SMART Surgery, was explicitly designed to spare the tiny nerve bundles surrounding the prostate in order to preserve sexual potency.
Men who undergo Dr. Samadis robotic prostate surgery have a reasonable chance of regaining complete erectile function for sex after prostate surgery.
Even though ejaculation will cease, you will still be able to enjoy sex after prostate surgery, as it is further explained.
So, prostate surgery does affect you sexually, but not in the ways you are thinking of.
Urination And Incontinence In The Postoperative Period
People who have undergone a prostatectomy will be taught how to operate the catheter before they leave hospital after the operation. The operation of most catheters is relatively similar and involves collecting the urine in a drainage bag, which can then be emptied into the lavatory. The drainage bag must be changed at appropriate intervals.
All men normally experience some level of incontinence after the catheter has been removed, particularly after involuntary bodily actions such as sneezing or laughing. It is also common to experience sudden impulses to urinate while the catheter is in place. This is called a bladder spasm. Bladder spasms should ideally not be particularly painful or occur very often. Therefore, it is wise to consult the doctor if they occur frequently enough to be bothersome or are accompanied by acute pain.
For most men, urinary problems are temporary and are effectively resolved by practicing pelvic floor and Kegel exercises regularly, as recommended by the doctor. Pads should be worn whilst urinary leakage is occurring and changed throughout the day as needed.
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Bowel Changes After Prostatectomy
After prostate surgery, it is normal for the patient to feel pain in the abdomen, in the penile area, and at the level of the back and shoulders. Theres also a sense of discomfort in the rectum, like there is a bowel movement concerned. This symptom may result in remaining bloated in the abdomen for a couple of days. However, walking and the right dietary plan can relieve gas and bloat.
Therefore, the days following a prostatectomy should include meals consisting of light ingredients such as sandwiches, soups, yogurt, and any types of liquid meals. Patients should refrain from meals that can cause gas, namely beans, onion, cauliflower, broccoli, or cabbage.
Nevertheless, at this point patients are likely to experience a lack of appetite. By the time the desire to consume food is reinstated, bowel movements may have already resumed their normal frequency.
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.
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After Prostatectomy: What To Expect
At the hospital : You should expect to be in the hospital for one night. At Johns Hopkins, all rooms on the urology floor are private. Here, nurses help patients get moving shortly after surgery to prevent blood clots and other postoperative risks.
First few days at home : After youre sent home, you might find that regular ibuprofen or acetaminophen will be sufficient pain management for the first few days. If over-the-counter medications arent enough, your doctor can help you with alternatives.
One week after surgery : After your surgery site heals, your catheter will be removed. This is usually seven to 10 days after surgery. This can easily be done at your doctors office. Some people decide to take out their catheter at home. If thats the case, ask your doctor for instructions first.
This is also about the time your surgeon will call you with the final pathology results. He or she will discuss what you should know and whether further treatment is necessary.
One month after surgery : Doctors recommend no strenuous activity or heavy lifting for at least one month after surgery. Most people take off work for three to four weeks. If you work from home, you could return to work sooner.
- Urinary incontinence
- Erectile dysfunction
Recovery from surgery takes time. These side effects are often temporary. However, if they are affecting your quality of life, ask your doctor about options that can help.
What Research Efforts Are University Of Florida Surgeons Involved In To Enhance Result Of Robotic Prostatectomy
University of Florida robotic surgeons are involved in several exciting research projects pertaining to robotic pertaining to robotic prostatectomy. First, we are involved with prospective collection of perioperative outcomes for each patient undergoing robotic prostatectomy. In this way, our robotic surgeons track quality of life and cancer outcomes following surgery to assess trends in outcomes and the effects of changes in surgical technique or new technology on these outcome measures. Second, we are investigating new imaging modalities to identify the precise course and location of the neurovascular bundles as well as cancer sites during this procedure using novel MRI technology. Lastly we are developing a robotic surgical simulator to help better prepare and train residents and fellows on the technical nuances of robotic surgery.
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