Prostatectomy

Prostate carcinoma, better known as prostate cancer, is a disease occurring in men when prostate tissue cells divide out of control, causing a mass identified as a malignant tumor. Located directly below the bladder, the prostate sits directly in front of the rectum.

No clear determining causation exists for prostate cancer. Diet and certain predispositions contribute to prostate cancer’s development. Factors increasing risks for prostate cancer’s development include:

• Age – Older men are at greater risk for prostate cancer.
• Race/Ethnicity – Caucasian men develop prostate cancer at half the rate of African American men. African American males also have a higher risk for developing aggressive forms of prostate cancer.
• Family history – Men whose families have a history of breast/ovarian cancer or with a brother or father with the disease are at higher risk for prostate cancer.
• Lifestyle – Smoking increases a man’s potential to develop prostate cancer.
• Diet and Exercise – Obese men consuming high fat diets while leading sedentary lifestyles have a prostate cancer incidence rate three times that of other men.

Virtually no symptoms signal early to mid-stage prostate cancer. Many of the same symptoms are associated with an enlarged prostate and late stage prostate cancer. These may occur concurrently with the following symptoms.

• Heightened urgency and need to urinate
• Difficulty urinating
• Blood appears in urine
• Pain and decreased ability for movement in the low back, abdomen, hips, upper thighs and pelvis

Treating prostate cancer includes many methods, including surgical intervention. If or when surgery becomes necessary, two types of robotic-assisted procedures may be used.

• Robotically-Assisted Laparoscopic Radical Prostatectomy: Using five to six keyhole incisions, the robotically-assisted laparoscopic radical prostatectomy offers many benefits. Shorter stays in the hospital, reduced pain and blood loss, and quicker recovery time. Similar to the human hand, robotic tools combine its best motion features without tremors. Precise, fine motions limit the scale of movements necessary. A mobile camera greatly magnifies the surgeon’s vision and illuminates the cancer for improved surgical technique and ability.

• Same-Day Robotic-Assisted Prostatectomy: Often be performed on an outpatient basis, same-day robotic-assisted prostatectomy has less than a one percent risk for bleeding and need for blood transfusions. Little pain occurs with this surgery, and patients see their doctor the day after surgery for routine exams. Within the week, bladder draining tubes are removed and top university hospitals no longer use abdominal drains.

Determining who is a candidate for robotic-assisted surgery can be difficult. Typically, men who are candidates for open surgery also qualify for a less invasive procedure. Men with these conditions present more of a challenge:

• Men who have had hernia repairs
• Males with large prostates weighing over 100 grams, which is about three and a half ounces
• Patients with a history of more than one prior pelvic or abdominal surgeries
• Morbidly obese patients

A robotic-assisted approach may spare nerves, allowing for normal sexual potency and continence.