What is a robotic prostatectomy?
The prostate gland is found only in men. It sits below the bladder and wraps around
the urethra. The prostate helps make semen. Prostatectomy is surgery to remove the
prostate gland. During the procedure, the seminal vesicles, nearby tissues, and sometimes
pelvic lymph nodes are also removed. When prostate cancer spreads, the pelvic lymph
nodes are often one of the first places it goes.
The prostate can be removed in two ways:
Open procedure. The surgeon makes a single large cut (incision) into the lower belly (abdomen) to
reach the prostate.
Robotic prostatectomy. This surgery makes several smaller cuts and removes the prostate using a laparoscope.
This is a thin tube with a tiny camera in it. Long, thin surgical tools at the end
of the laparoscope are used to remove the prostate. Your surgeon can move these tools
with the help of a robot. The surgeon uses controls and a computer screen to move
the small tools. You will want to find a surgeon who has experience doing this type
Why might I need a robotic prostatectomy?
Prostatectomy is used to treat prostate cancer that is confined to the prostate gland
and the seminal vesicles. The robotic system can help your surgeon in several ways.
The camera magnifies the area, helping the surgeon see tiny structures more clearly.
The robotic system can make steady, precise movements in small places that the surgeon
may have trouble reaching otherwise.
Compared with a standard open surgery, this type of surgery may have benefits. These
Shorter hospital stay
What are the risks of a robotic prostatectomy?
During this surgery, medicines may be used to put you in a deep sleep called general
anesthesia. In rare cases, spinal or epidural anesthesia may be used to make you numb
from the waist down. Risks from this procedure include:
Injury to nearby organs, such as the large intestines
Reactions to medicines used during the surgery
Stroke or heart attack during the procedure
Some side effects that you may have after surgery include:
Change in penis length
Injury to the rectum
Narrowing of the tube (urethra) in the penis that carries out urine
Swelling in the leg or genital area caused by removal of the lymph nodes (lymphedema),
this is rare
Trouble controlling bowel movements
Trouble controlling urine, called incontinence
Trouble getting or keeping an erection
There may be other risks, depending on your specific health condition. Talk with your
healthcare provider about any concerns before the surgery.
How do I get ready for a robotic prostatectomy?
Your healthcare provider will give you a checkup before the surgery. This is to see
that you’re healthy enough for the procedure. And that any health problems you have
are under control. You will also have tests done to make sure the cancer has not spread
to other parts of your body.
Your provider will explain the procedure to you and give you a chance to ask questions.
You will be asked to sign a consent form before the test. Read the form carefully.
Ask questions if anything is not clear.
Tell your healthcare provider if you are sensitive to or allergic to any medicines,
latex, tape, and local or general anesthesia.
Check that your provider has a list of all medicines, herbs, vitamins, and supplements
that you are taking. This includes both prescribed and over-the-counter medicine.
Tell your healthcare provider if you have a history of bleeding disorders or if you
are taking any blood-thinning (anticoagulant) medicines, aspirin, ibuprofen, or other
medicines that affect blood clotting. You may need to stop these medicines before
If you smoke, stop as soon as possible. This will improve your recovery and your overall
Your provider will tell you about any other specific things you need to do to get
ready for surgery. For instance, the day before the surgery, you may need to take
a laxative or bowel preparation to clear your colon.
Follow any directions you are given for not eating or drinking before the surgery.
Based on your medical condition, your healthcare provider may request other specific
What happens during a robotic prostatectomy?
Robotic prostatectomy requires a hospital stay. Procedures may vary depending on your
condition and your healthcare provider’s practices.
Generally, robotic prostatectomy follows this process:
You will be asked to remove any jewelry or other objects that might get in the way
You will remove your clothing and put on a hospital gown.
You will be asked to empty your bladder.
An IV (intravenous) line will be started in your arm or hand. Antibiotics and medicines
to reduce your risk of blood clots may be given.
You will be given anesthesia that puts you to sleep for the procedure. Or that makes
you relax and feel numb from the waist down.
Your heart rate, blood pressure, breathing rate, and oxygen level will be watched
closely during the procedure.
You will most likely lie on your back on a special table that holds your legs apart.
A soft, flexible tube called a catheter will be put into your bladder to drain urine.
If there is a lot of hair at the incision sites, it may be shaved off.
The skin over the surgical site will be cleaned with an antiseptic solution.
The surgeon will then make several small cuts into your lower belly.
The robotic arms will be placed over you, and the video camera and instruments will
be put into your belly through these cuts.
The surgeon will cut away your prostate, the seminal vesicles, and some nearby lymph
nodes and take them out through the small cuts. The urethra will be sewn to the bladder.
A new catheter will be placed into the bladder.
All of the tools will be removed and the cuts will be closed with skin glue, stitches,
or small strips of tape.
A bandage or dressing will be put on the sites.
What happens after a robotic prostatectomy?
After the surgery, you will be taken to a recovery room to be closely watched. Once
your blood pressure, pulse, and breathing are stable and you are awake and alert,
you will be taken to your hospital room.
You may get pain medicine, as needed, by a nurse. Or you may give it yourself through
a device connected to your IV line.
You can slowly eat solid foods as you are able to handle them.
After the surgery, your healthcare team will show you how to do breathing exercises
and movements while in bed to help your body recover. You may wear special stockings
on your legs that reduce your risk for blood clots. After resting the first day, you
may be encouraged to get up and move around. You may be able to go home the day after
The catheter that was put in to drain your urine will stay in place for a week or
two as you heal. You will be taught how to drain the catheter bag. Once it's removed,
you may have trouble controlling your urine. Your healthcare team can show you how
to do pelvic floor muscle exercises to better control your urine.
Follow all instructions from your healthcare provider. You will likely be told not
to drive for at least a week after the surgery. You will need to not do heavy exercise
for 3 or 4 weeks. You will also be taught how to care for the catheter. Keep any follow-up
appointments. The catheter will be taken out at one of these appointments.
Tell your healthcare provider if you have any of the following:
Fever or chills
Redness, swelling, or bleeding or drainage from the incisions
More pain around the incisions
Inability to have a bowel movement
Inability to urinate once catheter is removed
Changes in your urine output, color, or odor
Your healthcare provider may give you other instructions after the procedure, depending
on your particular situation.
Before you agree to the test or the procedure make sure you know:
The name of the test or procedure
The reason you are having the test or procedure
What results to expect and what they mean
The risks and benefits of the test or procedure
What the possible side effects or complications are
When and where you are to have the test or procedure
Who will do the test or procedure and what that person’s qualifications are
What would happen if you did not have the test or procedure
Any alternative tests or procedures to think about
When and how will you get the results
Who to call after the test or procedure if you have questions or problems
How much will you have to pay for the test or procedure