Robotic Radical Prostatectomy
Prostate cancer is the second most common type of cancer diagnosed in men and accounts for 15% of all cancers. Today, early diagnosis of prostate cancer is increasing thanks to 'multiparametric prostate MRI', which is a prostate-specific shot, and 'Fusion Biopsy', which can be performed with a target. In this way, functional results after the operation have become more important.
After the diagnosis of prostate cancer, bone scintigraphy, MR and PET-CT can be performed to see local and systemic spread. Depending on the patient's performance score, general condition and risk group, it is decided which treatment to be given together with the patient. Radical prostatectomy is the gold standard treatment method in patients with a 10-year life expectancy according to performance score and co-morbidities.
Robotic Prostate Cancer Surgery
Radical prostatectomy is performed open technique (retropubic, perineal), laparoscopic or robotically assisted. Robotic surgery has recently started to be preferred because it provides many advantages in prostate surgeries. With the help of robotic surgical systems, the dominance of anatomy, the convenience it provides in the removal of the prostate, which is a deep organ, and the protection of the surrounding tissues, the decrease in bleeding rates, early improvement in functional results and shorter hospitalization times.
Although it has been reported that open, laparoscopic and robotic surgery are not superior to each other in terms of oncological and functional results, it is thought that the results will change in favor of robotic surgery in the future with the increase in experience in robotic surgery.
Robotic Radical Prostatectomy
One of the 4 working arms of the robot is the optical camera that allows us to view the inside of the abdomen, and the others are the arms where the instruments that enable us to perform the operation can be used. After the patient is positioned appropriately, a hole is made around the navel, where the camera will be placed, and the abdominal cavity is inflated with the help of gas. Working channels called trocars are placed with 8-12 incisions of various sizes (4-5 mm) through which other working elements will be sent into the body.
It is made ready for the surgeon to switch to the robotic console by bringing the robot arms close to the environment and positioning (docking) by sending the working elements from the arms. After that, the surgeon removes the prostate in accordance with oncological principles, and then attaches the bladder to the remaining urinary canal with sutures, creates a new urinary canal and a urinary catheter is placed. At the end of the surgery, the prostate and its appendages, which are taken into the bag in the abdomen, are usually removed through the incision where the camera enters and sent for pathological examination.
Things to Know About Robotic Radical Prostatectomy
- The process takes 2 hours.
- It should be performed under general anesthesia, in operating room conditions.
- You only stay in the hospital for 3 nights under surveillance.
- He can take a bath on the fourth day.
- On the seventh day, the probe is withdrawn.
- On the seventh day he can travel.
- It can work on the fourteenth day.