Robotic Surgery Frequently Asked Questions

Q. What is Robotic Radical Prostatectomy? 

A. This procedure is also called da Vinci robotic prostatectomy. It is a minimally invasive surgical removal of the prostate involving the latest advancements in robotics and computer technology. 

It is a computer-enhanced minimally invasive surgical system consisting of three components:

• Surgeon Console
• Patient-side Cart
• Insite Vision System 

The Surgeon Console consists of the master controls the surgeon uses in order to manipulate the Patient-side Cart and the EndoWrist instruments. The surgeon’s hand movements are translated to the EndoWrists through the surgeon console. The instruments only move if the surgeon decides to move them. The robot is not in control of the instruments — the surgeon is. 

The Insite Vision System provides a 3-D view of the surgical field – a vast improvement over the 2-D view of laparoscopic surgery. This translates to a much better visual field and better depth perception. The high definition video cameras give a 10X to 15X magnification - a view the surgeon could never get with traditional surgery. This is particularly important in visualization of the prostate capsule, sparing the neurovascular bundles responsible for erectile function and reconnecting the urethra to the bladder. 

Q. How does a laparoscopic radical prostatectomy compare to open radical prostatectomy as far as cancer cure rate? 

A. The results of cancer control in both laparoscropic and open radical prostatectomy patients is essentially identical. This is confirmed in major institutions across the country where this procedure is being performed on a regular basis. 

Q. How many robotic prostate surgeries has Dr. Samadi performed? 

A. Dr. Samadi has performed more than 3,800 robotic prostate surgeries, giving him an almost unparalleled experience in the field. 

Q. Does the da Vinci prostatectomy robot perform the operation? 

A. Absolutely not! The robot is completely under the control of Dr. Samadi. The robotic arms enable him to operate in small spaces in the abdomen. 

Q. How does robotic prostate surgery differ from other surgical prostate cancer treatments? 

A. Robotic prostate surgery is a new approach that makes use of the da Vinci Surgical System, an innovative piece of robot-assisted technology. The System allows for the performance of minimally invasive prostatectomies with shorter incisions, enhanced visualization, and greater flexibility and control, thus minimizing blood loss and scarring while promoting a faster recovery. 

Q. How long does the da Vinci Robotic Prostatectomy take? 

A. Typically it takes 2 ½ to 3 hours depending on the size of the prostate, the patient’s anatomy and constitution, and the extent of surgery. This is comparable to the average time of open surgery. 

Q. How long do patients stay in the hospital after the procedure? 

A. The majority of patients are discharged the day after surgery. However, the time of discharge is decided on a case-by-case basis. By the second night, over 90 percent of patients are comfortable enough to go home. 

Q. How long will I have the catheter after the laparoscopic radical prostatectomy?

A. For open surgery, the catheter is removed after two to three weeks. However, with a laparoscopic prostatectomy, the catheter is removed seven days after the operation. This is one in our office guided by x-ray to ensure the urethra is properly connected to the bladder. 

Q. Will I be able to resume normal activities? 

A. Patients are often able to resume normal activities over time. Most activities may be resumed within four to six weeks, with some individuals returning to work as early as two to three weeks after the surgery. 

Q. How long will it take for my urinary control to return after laparoscopic radical prostatectomy? 

A. For the first few weeks, one needs to wear a protective pad. The return of continence is fast and, within a few weeks, over 95 percent of the patients have full control of their urination. An occasional patient exhibits mild stress urinary incontinence after surgery which is usually resolved by performing Kegel exercises.

Q. Will I be able to achieve an erection after laparoscopic radical prostatectomy surgery? 

A. Erection recovery can also be difficult and slow for some patients. The average time for the recovery of an erection is between six and 18 months, as nerves are slow to heal. In some individual cases, Viagra has helped patients. 

Q. Am I a good candidate for a da Vinci robotic prostatectomy? 

A. Men who are diagnosed with a localized prostate cancer are candidates for this procedure. Most patients who are candidates for open surgery would have an excellent outcome with this procedure. The indications for this surgery are very similar to open surgery.