Robotic Prostatectomy

Radical prostatectomy

This surgery is for organ-confined prostate cancer. The aim is to remove the whole prostate to achieve the best possible cure. The da Vinci robot does this well due to the 3-dimensional, magnified view, with instruments that give better dexterity with less damage to the nerves and sphincter muscle.

After the prostate is removed, the bladder has to be rejoined to the urethra. Here, the superior stitching capability gives better watertight stitching of the bladder to the urethra. Robotic offers faster recovery with less pain and bleeding. The surgery takes between 2 to 3 hours. Hospital stay is 3 days.

Dr Chin doing robotic prostatectomy

Complications include:

  • Urine leak; This occurs if the bladder-urethra stitching is not water-tight
  • Bleeding; This is usually < 200 ml
  • Urinary incontinence; This is due to weak or damaged pelvic floor muscles
  • Impotence; This is due to damage of delicate nerves to the penis.
  • Rectal injury; This can occur when dissecting the back part of the prostate. This can occur if the surgery is done too soon after biopsy

Robotic surgery has been shown to improve patient’s recovery because of:

  • No anastomotic leak or late strictures
  • No blood transfusion ( <1% occurrence)
  • No stress incontinence ( <1% chance)
  • No impotence – this depends on the age of patient and whether both or one nerves have been spared
  • No rectal injury ( <1% risk)