Robotic-assisted prostatectomy

In developed countries, more than 80% of all radical prostatectomies are performed with a robot. At the Department of Urology of F. D. Roosevelt University Hospital in Banská Bystrica, we have performed more than 4,000 robotic radical prostatectomies. Every year we perform more than 50% of all radical prostatectomies in Slovakia.

Robotic-assisted prostatectomy is a surgical procedure used to treat prostate cancer. The prostate is a gland that is part of the male reproductive and urinary system. Prostate cancer is a disease that mainly affects men over the age of 50. If prostate cancer is detected early, it can be successfully removed with a robotic-assisted procedure.

Robotic-assisted prostatectomy is a type of minimally invasive surgery that uses a special robotic system. The system allows the surgeon to handle the surgical instruments and the camera, which are inserted into the patient's abdominal cavity through small incisions, more precisely and more delicately. The surgeon controls the robotic arms from a console that shows a magnified three-dimensional image of the operating field. Robotic technology reduces the risk of damage to the surrounding nerves and blood vessels that are important for urinary and sexual function.

Robotic-assisted prostatectomy has several advantages over conventional open surgery, such as:

The most advanced surgical technique
Less blood loss and a lower need for transfusion
Less pain and a lower need for painkillers, because we use LISA (Low impact surgery)
A shorter hospital stay and faster recovery
Smaller scars and a better cosmetic result
A lower likelihood of complications such as infection, blood clots, incontinence or impotence

The operation is performed under general anaesthesia and at our department takes approximately 2 hours. It is performed through access ports into the abdominal cavity (trocars), through which special instruments are inserted that the surgeon uses to carry out the whole procedure.

The prostate is removed in a special plastic bag through a small skin incision. The end result is 5 small scars on the abdominal wall.

Recording of a real operation:

Robotic-assisted prostatectomy is a demanding and complex procedure that requires an experienced, trained console surgeon and specialised equipment. It is not suitable for every patient and can also have undesirable consequences, such as:

Possible injury to the bladder, urethra, bowel or other organs
Possible need for a transfusion or further surgery
Possible long-term or permanent loss of continence
Possible change in the quality of erections or complete inability to achieve an erection
Possible need for subsequent radiotherapy if the cancer has spread beyond the prostate

Before the procedure you need to undergo a thorough examination and a consultation with a urologist, who will assess your diagnosis, health, expectations and treatment options. The urologist will explain the course, risks and benefits of robotic-assisted prostatectomy and answer your questions. You will also be told how to prepare for the procedure, what to expect afterwards and how to look after yourself during recovery.

If you are interested in robotic-assisted prostatectomy, talk to your urologist and find out whether this treatment option for prostate cancer is suitable for you. Robotic-assisted prostatectomy is a modern and effective method that can improve your quality of life and prognosis.

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For more information about robotic-assisted prostatectomy, see the following sources:

Gallery

Operating theatre with the da Vinci robotic system

Anatomical illustration of the prostate and surrounding structures

Information for patients booked for robotic surgery at Roosevelt Hospital

Please bring to your hospital admission:

Pre-operative internal medicine examination and blood clotting tests
Pre-operative anaesthesia assessment (if you are admitted for surgery on a working day, we will do it at Roosevelt Hospital on the day of admission. If you are admitted on a Sunday, you must come to our admissions clinic on the Friday before your hospital stay so that we can send you for the anaesthesia check-up at our hospital)
Stop taking blood thinners, or switch them to low-molecular-weight heparin, 10 days before the operation
If you are registered for surgery elsewhere, you must cancel that registration, because your health insurance company will not allow us to book you for surgery with us.
The medicines you are currently taking
The signed patient informed consent form (you will receive it on admission, or you can print it here)
The results of imaging – CT, MRI – must be brought to the operation and also uploaded to the hospital PACS via the hospital's CT archive (in the connecting corridor between the outpatient building and the inpatient wing).

What to expect after robotic-assisted partial nephrectomy?

After the procedure you will be taken to the ward or, exceptionally and only if necessary, to the intensive care unit, where you will be monitored and treated. You will have a catheter to drain urine and a drain to remove blood. You will also receive antibiotics to prevent infection and an intravenous infusion with painkillers to relieve pain.

Post-operative care

After the operation you will stay in hospital for approximately another 2 to 3 days, depending on your health and how you recover. Under standard circumstances we remove the drain and the urinary catheter on the first day after the operation and check the wounds. If everything is fine, the patient is discharged home the following day.

After discharge from hospital you will need to follow the urologist's instructions, which include:

Taking blood thinners such as Fraxiparine for 28 days as prescribed
Checking the incision sites and caring for them as instructed
Drinking plenty of fluids to stay well hydrated

After this operation there are two situations that require you to come back to the hospital emergency department. The first is a temperature above 38 °C lasting more than 24 hours; the second is abdominal cramps and inability to pass wind. In that case an imaging examination is needed to find the possible cause of the problems.

Approximately one month after the operation you will come for a post-operative check-up, where we will go through the histology results (after every operation we send the specimen for histological examination) and agree on the next steps.