Robotic radical prostatectomy: removal of the prostate through small incisions with robot-assisted laparoscopy in prostate cancer. Magnified three-dimensional view, precise movement and faster recovery.
Radical prostatectomy is the operation in which the prostate and the seminal vesicles are completely removed in prostate cancer. When indicated, the lymph nodes in the pelvic region are removed during the same operation (pelvic lymph node dissection).
In robotic surgery, the operation is still performed by the surgeon. The surgeon controls the robotic arms from a console next to the patient; the arms hold slim instruments inserted through small incisions in the abdomen. The magnified three-dimensional view and wristed instruments make precise work easier in the narrow space around the prostate, with the aim of preserving the nerves and the structures that provide urinary control.
The decision for surgery is made by evaluating the stage and grade of the cancer, the PSA value, MRI and biopsy findings, and the patient's age and general health together. Other options such as active surveillance and radiotherapy are also discussed in detail during this consultation.
The robotic arms place slim instruments and a camera into the body through a few small ports in the abdominal wall. The surgeon controls them from a console; the instruments reach the prostate below the bladder.
From diagnosis to post-operative follow-up, every stage proceeds in a planned and predictable way.
The stage of the disease is determined with PSA, multiparametric prostate MRI, the biopsy result and additional imaging when needed. Treatment options are evaluated together.
An anesthesia assessment and routine tests are carried out. Your medications, especially blood thinners, are reviewed. Starting pelvic floor exercises before surgery is recommended.
Under general anesthesia, the prostate and seminal vesicles are removed through 5–6 small abdominal incisions, and the bladder is reconnected to the urethra. A nerve-sparing technique is used in suitable patients.
Discharge with a catheter after a short stay; the catheter is removed after about one week. The outcome is monitored with the pathology result and regular PSA follow-up.
Advantages during recovery compared with open surgery. For cancer control, the main determinants are the stage of the disease and surgical experience.
Several small incisions are used instead of one large abdominal incision. There is less pain after surgery and the scars are small.
Thanks to the magnified view and precise dissection, blood loss and the need for transfusion are lower than in open surgery.
Most patients are discharged within a few days of surgery and return to daily life more quickly.
The surgeon sees the operating field magnified and in three dimensions. Fine structures around the prostate can be distinguished more clearly.
In suitable patients, precise surgery aimed at preserving the nerves responsible for erection can be performed.
Patients usually get up and start walking on the day of surgery or the following day.
Partial nephrectomy is the operation in which, for kidney tumours, only the tumour is removed together with a thin margin of healthy tissue instead of the whole kidney. The rest of the kidney is preserved, which is important for long-term kidney function.
In the robotic method, the magnified three-dimensional view and wristed instruments allow the tumour to be removed precisely and the opening in the kidney to be repaired with sutures. During this step, blood flow to the kidney is stopped briefly if needed; the speed and precision of the robot help keep this time short.
It is generally considered the first option for small (mostly under 7 cm) and favourably located kidney tumours, and for patients with a single kidney, reduced kidney function or tumours in both kidneys. The decision depends on the size and location of the tumour and the patient's general health.
It is performed under general anaesthesia with the patient lying on the side, through 4–5 small ports in the abdominal wall. The operation usually takes 2–4 hours; the hospital stay is mostly 2–3 days. The removed tissue is examined by pathology and follow-up is done with regular imaging.
Radical cystectomy is the operation in which the bladder is completely removed for bladder cancer that has invaded the muscle layer and for some high-risk bladder tumours. In men, the prostate and seminal vesicles are removed together with the bladder; the lymph nodes in the pelvic region are also removed in the same operation.
After the bladder is removed, a new route is created for urine to leave the body (urinary diversion). This may be a channel made from a segment of the small intestine that opens onto the abdominal wall (ileal conduit), or a new bladder also made from intestine and connected to the urethra (orthotopic neobladder). In suitable patients, this step can also be done robotically, inside the body.
Compared with open surgery, it offers less blood loss, less pain and earlier mobilisation. Radical cystectomy is a major operation; the hospital stay is usually 7–10 days and recovery is followed closely. The most suitable urinary diversion is decided by evaluating the stage of the disease and the patient's general health together.
Common questions about robotic radical prostatectomy.
No. The operation is performed from start to finish by the surgeon. The robotic system is a tool that translates the surgeon's hand movements into small, precise instrument movements; it does not make decisions or move on its own.
In terms of cancer control, the results of the two methods are similar; the main determinants are the stage of the disease and surgical experience. The advantages of the robotic method are less bleeding, less pain, a shorter hospital stay and faster recovery.
Urine leakage is common in the early period after surgery, but it improves over time in the great majority of patients. Pelvic floor exercises speed up recovery. Permanent incontinence is rare, and treatment options are available if needed.
In suitable patients, the aim is to preserve erectile function with a nerve-sparing technique. Recovery of function may take time and varies from person to person. Medication and other supportive methods can be used during this period. There is no semen at ejaculation after surgery.
In most patients, surgery alone is sufficient. Depending on the pathology result and post-operative PSA values, some patients may need additional treatments such as radiotherapy or hormone therapy.
Bring your PSA, MRI and biopsy results. Let's evaluate together the most suitable treatment option based on the stage of your disease and your individual situation.