Prostatectomy - Removing the Cancerous Prostate
Removal of the cancerous prostate gland and certain surrounding structures is known as a radical prostatectomy. In the United States, 91% of prostate cancer diagnoses are estimated to be clinically localized (confined to the prostate with no regional lymph node or distant metastasis, also referred to as stages T1 or T2) when first detected1. Because the entire prostate gland is removed with radical prostatectomy, the major potential benefit of this procedure is a cancer cure in patients for whom the prostate cancer is truly localized. 2
Patients should discuss radical prostatectomy with their doctor to determine if they are an appropriate candidate. The two potential side effects that most concern patients considering a radical prostatectomy are incontinence and inability to achieve erections. Today, most patients are candidates for nerve-sparing radical prostatectomies when the cancer is detected early, and preventing nerve damage may significantly minimize the potential side effects of incontinence and impotence. The vast majority of patients that undergo a radical prostatectomy see a return of urinary continence and sexual function after a recovery period post-surgery, though there is no guarantee that these benefits will apply for every patient. The length of this recovery period depends on a variety of factors and patients should openly discuss what recovery they should individually expect with their doctor.
Types of Prostatectomy
Approaches to this procedure include traditional open surgery, conventional laparoscopic surgery or da Vinci Prostatectomy, which is a robotic-assisted laparoscopic surgery.
Traditional Open Prostatectomy
With a traditional open procedure, your surgeon uses an 8-10 inch incision to access the prostate. This approach often results in substantial blood loss and long, uncomfortable recovery.
Conventional Laparoscopy
Conventional laparoscopy uses a specialized surgical camera and rigid instruments to access and remove the prostate using a series of small incisions.
Conventional laparoscopy relies on rigid instruments and standard 2D video, technical limitations that can be challenging for the surgeon. Because of these drawbacks, conventional laparoscopy doesn’t lend itself well to complex procedures like prostatectomy. Therefore, very few urologists use this approach for prostatectomy.
da Vinci Prostatectomy
da Vinci Prostatectomy is a robotic-assisted radical prostatectomy performed in a minimally invasive approach. Surgeons have demonstrated (and widely published) results with da Vinci Prostatectomy that offer excellent rates of cancer control while speeding the return of urinary continence and sexual function.