Radical Prostatectomy (Removal of the Prostate)

Robotic Prostate SurgeryThe National Cancer Institute estimates there are more than 200,000 newly diagnosed cases of prostate cancer in the United States annually. Prostate cancer is the second leading cause of cancer death in men in the United States with approximately 25,000 men dying of it each year.

What Is the Prostate?

The prostate is a walnut-sized gland found in the male reproductive system. The normal prostate gland is quite small and weighs only about an ounce. It is somewhat firm; 30 percent of it is made up of muscular tissue, and the rest consists of glandular tissue. The prostate is located in front of the rectum just below the bladder, the organ that stores urine. It surrounds the urethra, the tube that carries urine from the bladder through the tip of the penis. In addition, the nerves responsible for erections are located on either side of the prostate. The main purpose of the prostate is to produce seminal fluid, which transports sperm during the male orgasm.

What Is Prostate Cancer?

Prostate cancer is the second most common type of cancer among American men. Cancer is a disease characterized by the uncontrolled growth and potential spread of abnormal cells. The human body is made up of billions of cells, which normally reproduce themselves by dividing so that growth occurs. Occasionally, cells abnormally grow into a mass called a tumor. Some tumors are benign (noncancerous). Others are malignant (cancerous). Prostate cancer occurs when a malignant tumor is formed in the prostate gland. If left untreated the cancer can grow and spread beyond the prostate into the surrounding tissues and lymph nodes. Moreover, the cancer can also spread to distant parts of the body such as the bones, lungs and liver. This spread is called metastasis. As a result of metastasis, many men experience aches and pains in the bones, pelvis, hips, ribs, and back.

What Are the Available Treatments for Prostate Cancer?

There are several solutions available for the treatment of prostate cancer. One solution is prostatectomy. This is the surgical removal of the entire prostate gland. It is usually performed to remove early stage prostate cancer before it can spread to other parts of the body. Often, the pelvic lymph nodes are also sampled for a biopsy as a precautionary measure to ensure the cancer has not spread. In most cases, taking out the prostate removes the cancerous tumor as well. If the cancer spreads outside of the prostate, it cannot be cured with surgery.

Most prostatectomy procedures are performed through large, open surgical incisions, which may result in lengthy and uncomfortable patient recovery, substantial blood loss and significant risk of impotence and incontinence.

Laparoscopic radical prostatectomy is a minimally invasive technique to perform radical prostatectomy procedures. The surgeon performs the operation by manipulating long hand-held surgical instruments inserted into the abdomen through small incisions. The surgeon views the operating field within the patient by using a laparoscope, a long, thin, lighted telescope, that transmits a two-dimensional view of the field onto a video screen.

There's also another minimally invasive method called the da Vinci™ Prostatectomy (dVP). This method involves incorporating the latest advancements in robotics and computer technology, which in turn allows your surgeon to perform minimally invasive procedures in a manner never experienced before.

What Is the da Vinci Surgical Systems?

The da Vinci® Surgical System is a totally "intuitive" laparoscopic surgical robot. It's not a robot in the sense of one you would imagine but one that integrates the latest advancements in robotics, computer-enhanced technology and the surgeon's skill. The system consists of several components:

  • a surgeon console
  • a patient sidecart
  • instruments and image processing equipment.

Will the da Vinci Surgical System Make My Surgeon Unnecessary?

On the contrary, it is designed to enable your surgeon to be more precise, advancing his/her technique and enhancing his/her capability to perform complex minimally invasive surgery. The System replicates your surgeon's movements in real time. It cannot be programmed, nor can it make decisions on its own to move in any way or perform any type of surgical maneuver without your surgeon's input.

What Are the Benefits of Using the da Vinci Surgical System over Traditional Open Methods of Surgery?

Some of the major benefits experienced by surgeons using the da Vinci® Surgical System over traditional open methods of surgery have been greater surgical precision, increased range of motion, improved dexterity and enhanced 3D visualization. Benefits patients have experienced over open surgery include: shorter hospital stay, less pain, less risk of infection, less blood loss and transfusions, less scarring and faster recovery and return to normal daily activities. None of these benefits can be guaranteed, however, as surgery can be both patient and procedure specific.

Jason D. Engel, MD, Director of Urologic Robotic Surgery at George Washington University Hospital, is widely considered a pioneer in the field of urologic robotic surgery.
Harold A. Frazier, II, MD, FACS is Clinical Director of Urologic Oncology at The George Washington University Hospital and head of the Prostate Cancer Program at The GWU School of Medicine.


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