Robotic Prostatectomy

01

How robotic radical prostatectomy is performed

The operation uses the da Vinci surgical system with 3D endoscopic vision and wristed instruments inserted through small incisions across the mid-abdomen.

A telescopic camera provides a magnified view of the prostate, bladder, urethra, nerves and pelvic muscles. This allows precise dissection of the prostate away from the bladder and urethra.

After the prostate is removed, the bladder and urethra are reconnected. A urinary catheter is left in place to drain the bladder while the connection heals.

02

Potential benefits

• Smaller incisions compared with open surgery.
• Less blood loss and lower transfusion requirement in many patients.
• Less pain and scarring.
• Shorter hospital stay and faster recovery in suitable patients.
• Earlier return to normal daily activities.
• Potential support for earlier continence and potency recovery when nerve-sparing is safe and appropriate.

03

Preparation before surgery

Pre-operative planning includes review of cancer stage, MRI or PSMA PET findings, general fitness, medications and anesthesia risk.

Some blood thinners or antiplatelet medicines may need to be stopped or adjusted only after advice from the prescribing doctor, surgeon or anesthetist.

Patients are usually asked not to eat or drink for a defined period before surgery. The final timing is individualized by the surgical and anesthesia team.

04

Risks and complications

Robotic prostatectomy is generally safe in experienced hands, but every major surgery has risks. These risks are discussed before surgery and depend on age, fitness, anatomy, cancer stage and previous surgery or infection.

• Bleeding or rarely transfusion.
• Infection at the urinary tract or incision sites.
• Adjacent organ or tissue injury, including bowel, blood vessels, muscles or nerves.
• Hernia at incision sites, although uncommon.
• Urinary incontinence that usually improves with time and pelvic floor exercises.
• Erectile dysfunction, influenced by age, baseline function, cancer location and nerve-sparing feasibility.
• Temporary leakage at the bladder-urethra connection, which may require catheter drainage for longer.

05

Hospital recovery

• Most patients stay in hospital for about 2-3 days.
• Walking usually starts early to reduce clot and lung complication risk.
• Diet is advanced gradually from liquids or soft foods to regular intake.
• A urinary catheter drains the bladder for approximately 7-10 days in many cases.
• A pelvic drain may be used and is often removed early depending on output.
• Transient shoulder discomfort, nausea, constipation or bladder spasms may occur and are managed with medicines and mobilization.

06

Recovery after discharge

• Daily walking is encouraged, but prolonged sitting or lying in bed should be avoided.
• Driving is usually avoided for at least two weeks or until cleared by the surgeon.
• Heavy lifting and strenuous exercise are avoided for about 4-6 weeks or as advised.
• Pathology results are usually reviewed within about a week after surgery.
• PSA testing usually begins after surgery and continues at regular intervals for surveillance.
• Kegel exercises support urinary control recovery and may be advised before and after surgery.