Robot Assisted Laparoscopic Prostatectomy
Private Health UHD are uniquely placed and are the only private hospital able to provide this treatment in the area.
What does the procedure involve?
A RARP uses keyhole surgery to remove the entire prostate gland together with the seminal vesicles (glands which make semen).
In selected cases some lymph nodes may also be removed during the surgery. At the Royal Bournemouth Hospital (RBH), this type of keyhole surgery has been performed with robotic assistance using the da Vinci® surgical system since October 2013. Prior to this, the keyhole surgery was performed using a conventional laparoscopic approach.
A RARP is performed under general anaesthetic so you will be asleep during the procedure. It involves the use of six ‘ports’ (small incisions) in your abdomen which allow access to your prostate. The wounds themselves are very small (five to ten millimetres), however the one by the umbilicus (belly button) will be bigger, as this is extended to remove the prostate at the end of your surgery. The size of this wound is determined by the size of your prostate.
With robotic surgery, the instruments, along with a high-definition 3D camera, are placed onto the robotic arms through the small port holes into your abdomen. The instruments are approximately 7mm in width. Your surgeon is then able to view a magnified, high-resolution 3D image of your prostate and surrounding tissues.
The instruments have a greater range of movement than the human hand and because of their size they allow the surgeon to carry out the operation using 3D imaging in a small space within the body. The operating surgeon sits in the same room, but away from the operating table at the control console. The surgeon is then able to carry out controlled and precise movements using robotic assistance. Although it is often called a robot, the da Vinci® system cannot move or operate on its own - your surgeon is 100% in control.
You should be aware that there is a small chance (around 0.5 per cent or one in 200) that your procedure may need to be converted to an open operation. In other words, once the operation begins the surgeon may find that it is not possible to proceed using the robot and may decide that an incision in your tummy is required to successfully remove the prostate. For this reason, if you are insistent that you would not agree to an open procedure under any circumstances, we would be unable to proceed with the robotic operation.
Why are the seminal vesicles removed?
The seminal vesicles are located behind the prostate and are intimately associated with the prostate. As a result, prostate cancer that has escaped the prostate can directly invade the seminal vesicles, hence they are removed at the time of surgery.
What are the alternatives to this procedure?
Alternatives to this procedure include active surveillance, external beam radiotherapy, brachytherapy or hormonal therapy. The options which are suitable for your type of cancer will have been discussed with you at your clinic appointment. If you would like to discuss any of these further then please contact your clinical nurse specialist team on 0300 019 4977.
Your discharge home
You will be discharged home the next day when:
- you are mobilising safely as you did before your admission
- you are able to care for your catheter and leg bags
- your pain is well-controlled on appropriate tablets
- you have been taught how to give yourself a daily injection to reduce the risk of blood clots
