The prostate is a walnut-sized gland located in front of the rectum, below the bladder and surrounding the urethra. Its main function is to produce a fluid that carries sperm during male orgasm. According to recent estimates, between 180,000 and 200,000 new cases of prostate cancer are diagnosed annually.

Prostate cancer is the second leading cause of cancer deaths in men, after lung cancer. In the United States, approximately 40,000 men die each year from this type of cancer. Prostate cancer is characterized by the uncontrolled growth and possible spread of abnormal cells.

This procedure is also called da Vinci robotic prostatectomy. It is a minimally invasive surgical removal of the prostate that involves the latest advances in robotics and computer technology.

It is a computer-enhanced minimally invasive surgical system consisting of three components:

• Console Surgeon
• Next to the patient's purchase
• Insite Vision System

The Surgeon Console consists of the master controls the surgeon uses in order to manipulate the Patient-side Cart and the EndoWrist instruments. The surgeon's hand movements are translated to the EndoWrists through the surgeon console. The instruments only move if the surgeon decides to move them. The robot is not in control of the instruments — the surgeon is.

The Insite Vision System provides a 3-D view of the surgical field – a vast improvement over the 2-D view of laparoscopic surgery. This translates to a much better visual field and better depth perception. The high definition video cameras give a 10X to 15X magnification – a view the surgeon could never get with traditional surgery. This is particularly important in visualization of the prostate capsule, sparing the neurovascular bundles responsible for erectile function and reconnecting the urethra to the bladder.

There are three surgical options for completely removing the prostate gland. These options are intended for patients with early-stage prostate cancer confined to the organ.

– Robotic Radical Prostatectomy
– Laparoscopic Radical Prostatectomy**
– Traditional Open Radical Prostatectomy

Men who are diagnosed with localized prostate cancer are candidates for this procedure. Most patients who are candidates for open surgery would have excellent results with this procedure. The indications for this surgery are similar to those for open surgery.

Definitely not, the robot is completely under the surgeon's control. The robot allows the surgeon to operate in small spaces in the abdomen.

This is a rare incident, having occurred once in the last three years. During this incident, the intervention is completed through laparoscopic surgery without the need to make an incision and open the patient's abdomen. It is important to be trained in open surgery, laparoscopy and robotic surgery for this very reason.

The catheter is removed five days after surgery.

It generally takes between 2.5 to 3 hours depending on the anatomy of the prostate and the patient's habits.

Radical laparoscopic prostatectomy is a minimally invasive surgical treatment for prostate cancer. It involves making small incisions to completely remove the prostate.

Radical retropubic prostatectomy is a surgical removal of the prostate, seminal vesicle and enlarged vessel through a low abdominal incision.

• Short stay in hospital
• Less blood loss
• Early catheter removal
• After surgery, minimal pain medication required
  10 to 15 times magnification of the doctor's vision
• Return to normal activities between one to two weeks after surgery
• Improved cosmetic results

The results of cancer control in patients who underwent laparoscopy are essentially identical to those in patients who underwent open prostatectomy. Most institutions across the country where this procedure is routinely performed can confirm this.

It usually takes between 2.5 and 3.5 hours. Each case is different due to the size of the prostate and the different anatomy. It is comparable to the estimated time for open surgeries.

Most patients are discharged the day after surgery. However, the timing is determined on a case-by-case basis. By the second night, more than 90 percent of patients are comfortable at home.

In open surgeries, the catheter is removed after two or three weeks. However, with laparoscopic prostatectomy, the catheter is removed three days after the surgical intervention. This removal is carried out in our offices under X-ray control to check the status of the anastomosis.

The average blood loss with this procedure is 150cc. This is why the risk of having to receive blood transfusions is minimal. The blood vessels collapse due to the high abdominal pressure and are monitored as a result of the visual magnification achieved with the use of the camera.

Every effort is made to save these nerves. One of the main advantages of this procedure is the fact that both nerves and vessels are enlarged and, as a result, it is easier to save them. It can take up to 6 months to regain sexual potency, and in some individual cases, taking Viagra helped patients significantly.

For the first few weeks you will need to wear pads. Continence will return within a few weeks, and over 95 percent of patients have complete control over urination. Occasionally, I have seen patients with stress incontinence after surgery, which is usually resolved by performing Kegel exercises.