How Is Robotic Surgery Different from Open Surgery for Prostate Cancer?

Advances in robotic surgery provide additional options for prostate cancer patients.

Robotic SurgeryRobotic surgery, in the past few years, has joined open surgery in use to treat patients with prostate cancer. During robotic surgery, surgeons are able to be more precise during dissection. Also, robotic surgery allows the bladder and urethra to be sewn back together in a much more precise fashion.

In using the robotic surgery technique, surgeons also have much better visibility and awareness when operating. Blood loss during robotic surgery is also significantly less. Patients are able to leave the hospital more quickly following robotic surgery. This all points into a new direction of treatment for prostate cancer as robotic surgery becomes a more common technique.

David Albala:  So, how is robotic surgery different from open surgery for prostate cancer?

Traditionally, open surgery has been used to treat the patients that have prostate cancer.  An incision is made and the prostate is removed with an open surgical technique that allows physicians to actually feel the prostate gland, take the gland out and then sew the bladder down to the urethra.  About 10 years ago, robotic surgery entered the treatment realm for prostate cancer and using the robot, we have been able to be more precise in doing our dissection and also allowing the bladder and the urethra to be sewn back together in a much more precision fashion.

Now, robotic surgery offers three advantages that I believe to the patient.  Number one, the surgeon can see things much-much better.  Everything is magnified.  It is on a TV camera and the surgeon is looking down into a small space and they can see the blood vessels and all the structures down in the pelvis extremely well.  Secondly, the blood loss from this procedure is dramatically less than what we see with open surgery.

Traditionally, blood loss from open surgery is about a liter of blood between 800 and 1 liter of blood.  In robotic surgery, the average blood loss is about 150 to 200 cc, so the risk of transfusion with robotic surgery is significantly less and then thirdly, the real benefit of robotic surgery is the patients are able to leave the hospital quickly.  Typically, with an open prostatectomy, patients would stay in the hospital for one to three days and they have a catheter left in place anywhere from 5 days to 10 days.  With robotic surgery, the catheters typically stay in place for one week, in some cases even shorter and traditionally, the patients are released from the hospital on the following day after surgery.

Dr. David Albala
Dr. David M. Albala is Chief of Urology at Crouse Hospital in Syracuse, New York and Medical Director for Associated Medical Professionals. He is considered a national and international authority in laparoscopic and robotic urological surgery and has been an active teacher in this area for over 20 years.

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