The basics and benefits of robot-assisted prostate surgery
It's estimated that, granted long life, just about everyone with a prostate will experience symptoms of it enlarging at some point. In addition to its necessary contributions to male sexual health, enlarging is just kind of what prostates do.
All told, 1 in 9 men will experience prostate disease at some point in their lives. If you're in your 60s, make that 50%. Over that, 90%.
What to do? Well, most prostate enlargement is benign and can simply be kept under close watch, lest it develop into something more troubling. But if it does become a problem, the prostate can be reduced or removed through a prostatectomy. And whereas a traditional prostatectomy can involve major surgery, a robotic-assisted laparoscopic prostatectomy accomplishes the same thing with greater accuracy and less risk.
“It’s a game-changer,” says urologic surgeon Robert Carey, MD, PhD, FACS, one of two surgeon specialists leading the First Physicians Group Prostate Clinic, where his multidisciplinary team treats everything from benign prostate enlargement to prostate cancer.
“This revolutionizes the way we do prostate surgery,” he says.
What is “Robotic-assisted Laparoscopic Prostatectomy”?
A robotic prostatectomy is a minimally invasive procedure that performs the same function as a traditional prostatectomy—removing part or all of the prostate—but is conducted using an advanced surgical system that improves precision and hastens recovery.
Instead of the large incisions that come with traditional surgery, robotic surgery relies on a series of small "keyhole incisions," through which miniature robotic instruments can enter the abdomen. Under the control of the surgeon and the surgical team, these instruments can perform all of the snipping and sewing that a traditional surgeon's tools would, but with increased range of motion and far greater precision.
Using advanced imaging equipment that provides a magnified three-dimensional image of the prostate and the surrounding tissues and blood vessels, the surgical team can operate efficiently and effectively, while preserving healthy tissue and nerves.
What Are The Benefits Of Robotic Prostate Surgery?
“Robotic surgery has a number of advantages,” says Dr. Carey. In comparison to traditional surgery, the benefits of a robotic prostatectomy are significant.
- Less pain
- Less blood loss
- Less risk of infection or complication
- Shorter surgery time
- Shorter hospital stay
- Quicker recovery
- Smaller scar
Many of these are due to the minimally invasive nature of the procedure, which uses those small keyhole incisions, instead of the much larger traditional abdominal incision.
And these advantages bring secondary benefits too, notes Dr. Carey.
With quicker recoveries and less pain, there's no need to prescribe the sorts of opioids that have led to an epidemic of addiction. "The majority of men who undergo a robotic prostatectomy are not even going to take narcotics," he says. "They'll take anti-inflammatory medication like Tylenol. They won't really have severe pain."
Does Robotic Surgery Have Risks?
All surgery entails a certain amount of risk. There's just no way around it. With robotic surgery, as with traditional surgery, there is the risk of bleeding, of complication and of potential damage to the surrounding tissue.
But with the minimally invasive approach that robotic surgery allows, and the precision with which it can be performed, these risks are much lower.
Potential Side Effects of Robotic Prostate Surgery
The potential side effects of a successful robotic prostatectomy are the same as the potential side effects of a successful traditional prostatectomy.
The two primary potential side effects are urinary incontinence and erectile dysfunction.
- Urinary incontinence, or the inability to control the release of urine, can occur post-prostatectomy, but is a side effect that often improves with time. If the problem persists, muscle strengthening exercises can be employed to great success.
- Erectile dysfunction can also be a temporary side effect. But in general, nerve-sparing techniques with robotic surgery can preserve sexual function and performance after a prostatectomy, though it is partially dependent on patient age and degree of sexual function before surgery.
Follow Up With A Doctor
Click the video to hear more from Dr. Carey himself. Or attend an in-person lecture with Dr. Carey this September 28, 2023, at 4:30pm, where he will be discussing the impact of robotic surgery, genomics, and sequenced therapy on cancer specific survival. Register here.
"Every day that I walk into the operating room, I'm not walking in there alone. I have people that I've worked with for 15 years, and we all have the same outlook: the most important thing in the world for the next 60-90 minutes is this person's life, and every little detail that needs to be done is going to be done." - Dr. Carey
If you or someone you know are experiencing signs of an enlarged prostate, such as difficulty urinating, frequent urination or urinary incontinence, contact the specialists at Sarasota Memorial Urology Services or our First Physicians Group Prostate Clinic.
Written by Sarasota Memorial copywriter Philip Lederer, MA, who crafts a variety of external communications for the healthcare system. SMH's in-house wordsmith, Lederer earned his Master's degree in Public Administration and Political Philosophy from Morehead State University, KY, and suffers from ego enlargement.