Robotic Prostatectomy for Prostate Cancer

Robotic Surgery - Robotic Prostatectomy for Prostate Cancer

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About Robotic Prostatectomy

Prostate cancer, a malignancy that develops in the prostate gland, is often treated successfully in its early stages with surgery. Surgeons who treat prostate cancer have twin goals: eradicating the patient's cancer while safeguarding the nerves that govern urinary and sexual function. Surgeons with the most extensive experience performing robotic prostatectomy are more likely to achieve these goals.

Robotic prostatectomy, also know as robot-assisted laparoscopic prostatectomy, is the most advanced treatment option for patients who are candidates for surgery. Operating through five or six tiny holes in the abdomen, surgeons remove the cancerous tissue while preserving the vital nerves and arteries that control bladder and sexual function. This nerve sparing prostatectomy approach helps men retain their urinary control and sexual function.

In the hands of an experienced robotic surgeon, robotic prostatectomy offers patients a shorter hospital stay, less blood loss, significantly less pain, a faster recovery, improved urinary continence and sexual function, less scarring, and excellent clinical outcomes.

The Robotic Surgery Program of Columbia University's Department of Urology at NewYork-Presbyterian Hospital, led by Dr. Ketan K. Badani, is one of the most experienced robotic prostatectomy teams in the world. Dr. Badani has performed over 1600 robotic surgeries, and was the first to bring the next generation robotic technology to New York City. He has mentored robotic prostatectomy on five continents, and his work on maximizing sexual function and urinary continence after robotic prostatectomy has been published in several peer-reviewed journals. Recently, Dr. Badani published his book written for patients titled, "Robotic Prostatectomy: Is it for you?" the first of it's kind designed to give a comprehensive overview of robotic prostate surgery. The book is widely available on amazon.com. Our team of robotic sugeons at New York Presbyterian perform more robotic prostatectomy procedures each year than do doctors at any other medical center in the country.

Robotic Prostatectomy with the da Vinci Robot

Surgeons here perform minimally invasive robotic prostatectomy procedures using a laparoscopic surgical robotic unit known as the da Vinci Surgical System. With da Vinci prostate surgery, miniaturized surgical instruments enable surgeons to manipulate tissue with great accuracy and remove the patient's prostate gland while minimizing harm to the surrounding tissues. Da Vinci prostate surgery provides surgeons with significantly enhanced magnification of the surgical field, making it easier for them to see and avoid the important nerves that run through the prostate, reducing the risk of urinary incontinence and sexual dysfunction.

Robotic Prostatectomy and Cancer Control

During robotic prostatectomy procedures urologists can dissect the tissue around the prostate precisely and safely remove cancerous tissue while preserving healthy nerves and arteries that control normal bladder and sexual function. Our studies demonstrate that cancer control is excellent and comparable to the best traditional open surgery. Robotic prostatectomy has been performed in the United States for only 7 years, so the longest cancer control data for this approach is five years long, and robotic prostatectomy has excellent five-year cancer cure rates (Badani et al. Cancer Nov. 2007, 110(9):1951-8). These results, coupled with improved sexual function after surgery, demonstrate the advantages of robotic prostatectomy.

Sexual Function After Nerve Sparing Robotic Prostatectomy

Recovery of sexual function after robotic prostatectomy varies from man to man, but studies show that men who undergo robotic prostatectomy have a quicker return of sexual function than those who undergo open surgery. Columbia Urology's researchers found that up to 93% of men with normal erections before surgery were having sexual intercourse by one year after the operation.

In men who are candidates for enhanced nerve sparing, we can perform enhanced nerve sparing prostatectomy techniques to preserve not only the major bundles of nerves and anteries that control erection function, but also the accessory nerves that assist and contribute to better sexual function after surgery. We perform this type of nerve sparing prostatectomy procedure using athermal techniques (by avoiding cautery and heat) near the delicate nerves that minimizes injury. This has shown to improve overall success rates in men with normal sexual function, and also, allow men to return to sexual activity sooner after surgery.

Most patients who undergo a robotic prostatectomy procedure (including those with nerve sparing prostatectomy techniques) only spend one night in the hospital and go home the next day. Robotic prostatectomy patients have a fast recovery. They are walking the day of their surgery because of their minimal blood loss and tiny their incisions, which cause no pain.

Not all men with prostate cancer are candidates for robotic prostatectomy. Schedule a meeting with a Columbia Urology Robotic Specialist to find out more.