Lahey Health is now part of Beth Israel Lahey Health

by Carmack A
(Robotic Prostatectomy)

Definition

A prostatectomy is the removal of the prostate gland. The prostate sits just below the bladder in men. It makes milky fluid in semen.

The doctor will use robot arms to remove the tissue. These arms can do very precise movements which may lessen damage to other tissue. The surgery can be done through small incisions in the belly. It leads to a faster recovery than open surgeries.

Reasons for Procedure

This type of prostatectomy is done to remove cancer in the prostate. Nearby tissue may also be removed to make sure all cancer has been removed.

Possible Complications

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review possible problems such as:

  • Bleeding
  • Infection
  • Blood clots
  • Harm to nearby structures

Nearby nerves and other structures can be affected or damaged. It may lead to:

  • Problems passing urine—often short term
  • Problems with erections—can improve with time

The risk of problems is higher if you:

  • Smoke
  • Drink
  • Have long-term disease such as diabetes or obesity

What to Expect

Prior to Procedure

Leading up to the procedure:

  • Talk to your doctor about the medicines you take. You may be asked to stop taking some medicines up to 1 week in advance.
  • Arrange for a ride home from the hospital.
  • Do not eat or drink anything after midnight before the procedure.

Anesthesia

General anesthesia will be used. You will be asleep during the surgery.

Description of the Procedure

Small cuts are made in the belly. Gas is passed into the belly. It will prop up the area to make it easier to work in. The robot arms pass small tools through the cuts. One arm will have a camera that creates a 3D image for the doctor.

The doctor will be sitting nearby at a console. Controls will let the doctor make small, precise movements with the robot arms. The robot can also reach angles that are hard for human hands. It may help to avoid damage to nearby structures like nerves needed for an erection.

The prostate tissue will be cut out. Other nearby tissue may also be removed if the cancer has spread. The doctor will leave as much healthy tissue as possible. The removed tissue can be pulled out with the robot arms. Tissue will be sent for testing. There will be a gap between the bladder and urethra where the prostate was. The bladder will be sewn back to the urethra to close this gap. When work is done, the tools will be removed. The cuts are closed with stitches and bandaged. A catheter will be left in place to allow the stitches in the urethra to heal.

Immediately After Procedure

How Long Will It Take?

2-3 hours

How Much Will It Hurt?

Anesthesia will prevent pain during surgery. You will have some soreness after the surgery. Medicine will help ease pain.

Average Hospital Stay

You will need to stay overnight. The stay may be longer depending on your recovery time.

Post-procedure Care

At the Hospital

You will be taken to a recovery room. The care team will watch your blood pressure, pulse, and breathing. Recovery may also include:

You will be taken to a recovery room. The care team will watch your blood pressure, pulse, and breathing. Recovery may also include:

  • Pain medicine
  • Medicine to prevent blood clots
  • Taking short walks as soon as you are able

You will have a catheter so you can pass urine into a bag. It will stay in place for about a week while the area heals.

During your stay, the care team will take steps to lower your chance of infection such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your wounds covered

There are also steps you can take to lower your chances of infection such as:

  • Washing your hands often and reminding visitors and your care team to do the same
  • Reminding your care team to wear gloves or masks
  • Not allowing others to touch your wounds
At Home

It will take some time for the urethra to heal. A catheter will be needed during this time.

Swelling and changes in the area can also affect erections. This may improve over time.

Intense physical activity may be restricted for 1-2 months.

It will take some time for the urethra to heal. A catheter will be needed during this time.

Swelling and changes in the area can also affect erections. This may improve over time.

Intense physical activity may be restricted for 1-2 months.

Call Your Doctor

Call your doctor if any of these occur:

  • The wounds open up
  • Stitches come out
  • Signs of infection such as fever or chills
  • Redness, swelling, pain, bleeding, or drainage from the wounds
  • Catheter is not draining as it should
  • Medicine not helping your pain
  • Ongoing nausea or vomiting
  • Breathing problems
  • Pain in your chest or lower leg

Call medical team immediately if the catheter falls out.

If you think you have an emergency, call for emergency medical services right away.

RESOURCES

American Cancer Society  https://www.cancer.org 

Urology Care Foundation  https://www.urologyhealth.org 

CANADIAN RESOURCES

Canadian Cancer Society  http://www.cancer.ca 

Health Canada  https://www.canada.ca 

References

Management of localized or locally advanced prostate cancer. EBSCO DynaMed website. Available at:  https://www.dynamed.com/topics/dmp~AN~T905839/Management-of-localized-or-locally-advanced-prostate-cancer . Updated July 1, 2019. Accessed August 6, 2019.

Prostatectomy: What to expect during surgery and recovery. Johns Hopkins Health website. Available at: https://www.hopkinsmedicine.org/health/conditions-and-diseases/prostate-cancer/prostatectomy-what-to-expect-during-surgery-and-recovery. Accessed August 6, 2019.

Robotic prostatectomy. Johns Hopkins Health website. Available at: https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/robotic-prostatectomy. Accessed August 6, 2019.

Robotic prostatectomy. NYU Langone Health website. Available at: https://med.nyu.edu/robotic-surgery/physicians/procedures/z-procedures-guide/robotic-prostatectomy. Accessed August 6, 2019.

Robotic prostatectomy. UW Health website. Available at: https://www.uwhealth.org/urology/robotic-prostatectomy/10527. Updated March 22, 2012. Accessed August 6, 2019.

Revision Information

  • Reviewer: EBSCO Medical Review Board Adrienne Carmack, MD
  • Review Date: 10/2019
  • Update Date: 10/29/2019