Robotic Surgery for Prostate: Benefits, Risks & Recovery

Prostatectomy is a surgery where the surgeon removes a part or the entire prostate gland. This is the best treatment option for certain specific prostate conditions. It is the most common treatment option for prostate cancer or benign prostatic hyperplasia.

Prostatectomy can be done in multiple ways: open surgery, minimally invasive laparoscopic surgery, or robotic surgery. Based on your condition, our expert urologists will suggest the mode of surgery.

Robotic prostatectomy is an advanced and efficient procedure, where the surgeon will precisely remove the prostate with the use of a robotic system.

It offers great precision, short hospital stays and better recovery.

Read on as we explore the benefits, risks, success rates, how to prepare for the surgery and your recovery after robotic prostate surgery in this blog.

What is Robotic Prostatectomy?

Robotic prostatectomy is a minimally invasive surgical procedure. This involves a robotic system like a CMR Versius surgical robot or da Vinci robotic surgical system, where the surgeon removes a part or the complete prostate gland. The robotic system helps the surgeon operate with utmost precision. The robotic arms are controlled by the surgeon from a console.

The surgery is recommended for patients where the cancer has not spread beyond the prostate gland.

There are two types of Robotic Prostatectomy:

Radical prostatectomy

This is a complete removal of the prostate gland. The surgeon removes the fat and tissues around your prostate. 

Simple/Partial prostatectomy

Removal of the inner portion of the prostate is a simple prostatectomy.

Robotic Prostatectomy Procedure

Step 1: The surgeon makes a small incision or several tiny incisions. (Single-port or multi-port prostatectomy) 

These incisions are not bigger than 3/4th of an inch.

Step 2: The Surgeon inserts a laparoscope and robotic surgical equipment through the incisions

Step 3: Removal of the prostate gland and seminal vesicles from the surrounding tissues.

Step 4: Reattachment of your urethra to your bladder using small sutures.

What are the Benefits of Robotic Prostate Surgery

The main advantage of prostatectomy is treating prostate cancer or BPH. Robotic Prostate Surgery provides many benefits when compared to open surgery,

• Minimally Invasive Surgery

The smaller incisions help with

• Less pain

• Minimal scars

• Less infection risks

• Shorter Hospital Stay

Hospital stay is reduced to 3-4 days from a 5-7 day stay for traditional surgery.

• Fast Recovery

Recovery starts much sooner, and patients can resume their routine life within 2-3 weeks.

• Better Precision

The surgeon’s experience is backed by the latest robotic technology, providing better precision. This results in reduced damage to the surrounding tissues and nerves.

• Better Cancer Control

In the early stages, the precise removal of the cancerous tissue helps to lower the recurrence of prostate cancer.

What is the Success Rate of Robotic Prostatectomy

Robotic prostatectomy offers high success rates in cancer tissue removal and long-term survival.

There are many aspects of Robotic Prostatectomy:

• Oncology (Cancer) Outcomes

Studies say there is a 95% success rate in cancer tissue removal.

• Long-term survival

Studies show 97.6% survival from cancer-related prostatectomy and about 85% from any cause.

• Urinary incontinence and ED

ED and incontinence are potential side effects of the surgery, although they are temporary. This can be effectively managed with medication and therapy.

• Minimally invasive surgery

The advantages of the procedure also have a positive effect on success rates.

The success rate of robotic prostate surgery depends on:

• Cancer Stage

• Patient Condition

• Patient’s overall health

• Lifestyle factors

Robotic prostatectomy provides 85-95% cancer control success in the early stages.

The long-term survival rates are 80-90%

According to Mayo Clinic and Cleveland Clinic’s studies, robotic prostatectomy has better and superior outcomes when compared to traditional open surgeries.

How to Prepare for Robotic Prostatectomy Surgery?

Preoperative preparation is crucial for the surgery. Here are a few things you need to know:

Evaluation

• A cystoscopy may or may not be done to check for

• Prostate size

• Examine the urinary system.

• Blood tests

• Tests to

1. 1. Measure prostate functions

   2. Measure urine flow

• ECG

• Chest X-ray

• PSA (Prostate-Specific Antigen) levels

• MRI or bone scan 

Medication

• Inform your care team about all the medicines and supplements you consume

• Avoid over-the-counter medication unless advised by the doctor

• Avoid blood thinners a week before surgery.

Diet/ Food Restrictions

• Have light meals the day before

• Fasting before surgery

You will be advised not to consume food and water from the previous night.

Emotional & Mental Readiness

• Discuss all your concerns with the doctor, whether it be physical or emotional.

• Be ready psychologically for the after effects and discuss how well and by when you will recover completely. This will provide you with confidence.

Arrangements post surgery

Understand how long you will be spending in the hospital. Prepare yourself with all the essentials required for the period. Also, book an advance ride home, as you will not be able to ride after surgery.

What to Expect After the Procedure?

• You will be on monitored pain medication through IV and later moved to prescription pills.

• You will be advised to walk after a day or two.

• You shall be discharged within 2-4 days after surgery.

• Most people need a urinary catheter for 15 days after surgery

• You will resume your routine over 4-6 weeks

• Regular follow-ups to be maintained

• You will be able to resume sexual activity after complete recovery. (Discuss with your doctor for clear answers)

What are the Risks and Side Effects of Robotic Prostatectomy

Just like any other surgery, there are a few risks of robotic prostatectomy:

• Urinary Incontinence

Loss of bladder control may be temporary; with proper management, it goes away over time.

• ED (Erectile Dysfunction)

Trouble having or keeping an erection post-surgery. Consult your doctor to know when you can resume sexual activity.

• Bleeding

This is rare but possible at the incision sites or can be internal bleeding.

• Blood Clots

You will be advised to move post-surgery and use compression stockings to reduce the risk of blood clots.

• Anaesthesia-related risks

Nausea or some mild complications, in rare cases.

• Urinary tract infection

Rare but possible, your doctors will help you with medication for effective management.

• Narrowing of the urethra

Very rare, but treatable

• Damage to the intestine or rectum

Very rare, but treatable

• Healing Problems

When the wound does not heal well

• Need for blood transfusion.

• Fluid buildup at the surgical site

• Little or no ejaculation (Dry orgasm)

• Depression

Recovery After Robotic Prostatectomy

Hospital Stay

• 3-4 days

• Catheter 15 days

Home recovery

• Avoid heavy lifting

• Avoid any strenuous activity for 6 weeks

• Walk regularly to avoid blood clots

• Follow all instructions to treat your wounds

• Follow Catheter hygiene

Diet

• Start with soft food

• Hydration is the key

• A High-fibre diet is recommended

Medications

• Adhere to all medications prescribed by your doctor.

Follow-up appointments

• Do not miss your follow-up consultations. It is important to know the recovery graph.

• PSA testing within 8 weeks

• PSA monitoring every 3 months

Sexual Recovery

• Baseline sexual function may take 6 months to 1 year

• Your doctors might recommend

• PDE5 inhibitors

• Vacuum erection devices

• Counselling

Pelvic floor exercises and physiotherapy help improve urinary control faster.

Who is a Good Candidate for Robotic Prostate Surgery?

Robotic Prostatectomy is the best option for:

• Patients who are diagnosed with localised prostate cancer

• Patients suffering from BPH requiring surgical intervention

• Patients who prefer faster recovery with minimal scarring

• Younger patients who are looking for options that are safe to preserve their sexual and urinary functions

Results of a Robot-assisted Prostatectomy

• Less pain

• Less blood loss

• Short hospital stays

• Quick recovery

• Easing of urinary symptoms

• Easing of complications from blocked urine flow, like:

• Frequent urination

• Urine urgency

• Trouble starting urination

• Prolonged urination

• UTIs

Robotic Prostatectomy in India: Availability and Cost

Cost of Robotic Prostatectomy in India

The cost of the surgery ranges from ₹2.5L to ₹5L

Factors affecting the cost are:

• Hospital Type

• Technology availability

• City

• Surgeon experience

• Type of robotic system

As the technology is limited, only a few private hospitals in Bangalore, Chennai, Delhi, Mumbai, and Hyderabad offer robotic surgery facilities.

Most health insurance policies and government schemes cover robotic prostatectomy for prostate cancer. It is advised that you speak to your insurance provider before you plan the surgery.

Please note: The surgery cost may vary based on the type of ward selected, medications, and any additional procedures, etc.

Robotic Prostatectomy vs Open Prostatectomy

 

Is Robotic Surgery Right for You?

Robotic prostate surgery offers

Minimally invasive, high precision, and better recovery outcomes.

The decision to choose this option should only be made when your urologist or uro-oncologist has advised the same. The doctors will decide if it is safe for you based on

• Your age

• Your overall health

• Cancer stage