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Robot-assisted Prostatectomy

If you have been diagnosed with prostate cancer, your urologist may recommend a radical prostatectomy to remove the gland and prevent the disease from spreading.

Advances in technology and techniques have made it possible to perform these procedures with the smallest of incisions and unmatched precision using the da Vinci Surgical System®. Ten-year survival rates of patients who had a robot-assisted prostatectomy are greater than 90%.

The specialists at the UCI Health Comprehensive Prostate Cancer Program lead the way in performing successful robot-assisted prostatectomies. They also developed a cooling technique that has dramatically improved survival and preservation of urinary continence and sexual function.

Called hypothermic robot-assisted radical prostatectomy, this procedure involves cooling the muscles and tissue around the prostate during surgery. By preventing inflammation and swelling, the surgeon is able to remove the prostate without injuring the urinary sphincter or the delicate nerves that control sexual function.

Combining this technique with the use of the da Vinci system, our surgeons have achieved excellent results for our patients, including:

  • Reduced blood loss
  • Nearly zero blood transfusions
  • Low infection and complication rates
  • Earlier recovery and return to work

How robot-assisted prostatectomy works

Traditional open prostate surgeries involve a large incision in the lower abdomen to access the prostate. A minimally invasive procedure involves a few small incisions the size of a dime. The surgeon inserts small tubes called ports into the incision sites to create a channel for surgical tools and an imaging device.

The abdomen is inflated like a balloon to give the surgeon room to operate with the laparoscopic devices attached to the miniature robotic arms of the da Vinci system. The surgeon operates the arms at a remote console where the surgical field can be seen in magnified, three-dimensional detail. An assistant is seated by the patient’s side to help as needed.

Before the surgical procedure begins, the patient is put to sleep with a general anesthetic, then a cooling balloon device is placed in the rectum to keep the tissues surrounding the prostate at about 50 degrees Fahrenheit. The patient remains asleep as the surgeon begins dissection of the prostate.

Once the prostate has been removed and margins are checked to ensure that all the cancer tissue has been eradicated, the robotic arms are retracted and the surgeon sutures the tiny incisions shut.

Patients generally are discharged from the hospital about 24 hours after the procedure.

View a video of a robot-assisted prostatectomy ›

What to expect after surgery

For about a week after surgery, patients urinate through a catheter inserted at the beginning of the surgery. The catheter allows continuous drainage of the bladder into a small external collection bag that is emptied as needed. Once the catheter is removed, most men leak urine for a period of time.

Most patients are able to return to work in a few weeks and resume more vigorous activities in about six weeks.

Regaining function

Recovery of urinary continence can take weeks to as long as 18 months. Permanent incontinence after robot-assisted prostatectomy is rare when the procedure is performed by an experienced surgeon.

Patients with good erectile function before surgery have a good chance for full recovery if a nerve-sparing procedure was performed as part of the prostatectomy. But healing can take six to 24 months.

Questions? Call us at 714-456-6068.

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