Robotic Prostate Surgery Frequently Asked Questions
Q: What is robotic radical prostatectomy?
Robotic radical prostatectomy is minimally invasive, or laparoscopic, surgery to remove the cancerous prostate gland and some of the tissue surrounding it. At Mount Sinai, Dr. Ashutosh (Ash) K. Tewari, Chairman of the Urology Department, performs all robotic prostatectomies himself using a state-of-the-art robotic system called the da Vinci® Surgical System, which he pioneered and has evolved into ART™ (Advanced Robotic Technique). The ART method, which combines an array of innovative techniques developed over many years by Dr. Tewari, is not available anywhere else. It is an optimal treatment for most patients with localized prostate cancer, minimizing the potential for urinary and sexual side effects and speeding recovery time compared to other surgical procedures.
Q: How many robotic prostate surgeries has Dr. Tewari performed?
Dr. Tewari is one of the foremost leaders in robotic prostate surgery and prostate cancer research. A pioneer of the da Vinci® robotic surgery for prostate cancer, he has performed more than 5,500 robotic prostate surgeries (surgeries to remove the entire prostate) to date – making him one of the most experienced robotic prostate cancer surgeons in the world. He was part of the team performing the first robotic prostate cancer surgery at Henry Ford Hospital, where robotic prostate cancer surgery originated in the United States.
With robotic prostatectomy, the success of the surgery depends on the skill and experience of the surgeon. Less than a handful of surgeons worldwide have Dr. Tewari’s experience and comparable outcomes with this procedure.
Q: How long will I have to stay in the hospital after surgery?
The majority of Dr. Tewari’s da Vinci® prostatectomy patients are discharged and return home within 24 hours of their robotic surgery. Learn more about what happens after the surgery
Q: Will I be able to father children after my robotic prostatectomy?
Robotic prostatectomy will not affect your interest in or desire to have sex, nor your ability to experience orgasms. However, you will no longer be able to ejaculate after the surgery due to the fact that the semen is produced in the seminal vessel and prostate, which have been removed. This means that you will be unable to father children. This will be true regardless of who performs the surgery. Sperm banking is an option you can pursue if you think you might want to father children in the future.
Q: Will I be to have erections after robotic prostate surgery?
A number of factors are involved in regaining erectile function, including the stage of your cancer and the strength of erections you had prior to surgery. The ART surgery, pioneered by Dr. Tewari, is designed to eradicate the cancer while minimizing damage to the nerves responsible for erectile function. Most of Dr. Tewari’s patients do regain the ability to have erections, but it is a gradual process – one that can take up to a year (or more), with erections usually improving with time. Learn more about sex after prostate surgery
Q: How soon will I be able to resume normal activities?
You will be able to start walking and climbing stairs as soon as you get home. You should be able to return to work within two to three weeks of the operation, depending on the type of work you do. However, you should wait to begin driving for at least two weeks and not do any heavy exercise (such as jogging, weight lifting, and bicycle riding) for three to four weeks.
Q: How soon after surgery can I shower and bathe?
It is fine to take a shower any time after you get home, but you should avoid taking a bath until after the catheter is removed (which will be approximately nine days after the surgery). You are also advised to leave the bandages covering the incision area on for three to four days. Be careful, too, when stepping out of the shower to pat, not rub, the incision area dry.
Q: Will I have a urinary catheter after the surgery?
Yes. When you leave the hospital, you will have a urinary catheter (a thin, flexible tube) placed in your bladder to make sure that all urine is draining and to smooth the way for healing. A follow-up, in-office appointment will be scheduled approximately nine days after your surgery, at which time Dr. Tewari will remove the catheter. This is a relatively pain-free procedure. At that visit, Dr. Tewari may request that you have a cystogram, a type of x-ray to make sure there is no leakage at the bladder/urethra connection.
Q: Will I have normal urinary control after this procedure?
Some men have normal urinary control immediately following ART prostate surgery. However, most men leak some urine immediately following the surgery and then gradually regain control in the weeks following the removal of the catheter. Most of Dr. Tewari’s patients who had normal urinary control prior to surgery achieve it again within three to18 months of surgery. This is attributable to Dr. Tewari’s meticulous surgical skill and the special technique he developed for preserving and restoring the urinary control muscles that is a unique part to the ART procedure he performs. Learn more about urinary control after robotic prostate surgery
Q: Will I need to donate my own blood to have available for transfusion during the surgery?
No. You will not need to donate your own blood in advance because blood loss is minimal. The robotic prostatectomy technique used at Mount Sinai includes strategies to avoid bleeding. Less than one percent of our patients require a blood transfusion or need re-exploration to control any bleeding issues.
Q: What should I expect during my first visit?
During your initial prostate cancer evaluation visit, you will be examined by Dr. Tewari and members of his clinical team, who will also review your clinical records. Your suitability for ART robotic prostate surgery will be assessed and discussed with you. You will have ample opportunity to bring up any concerns and ask any questions you may have. If you are a suitable robotic prostate cancer surgery candidate and you wish to schedule the procedure, you may begin that process right after you have been evaluated. Alternatively, you may wish to take time to consider the decision and contact us at a later date to schedule this.
If you decide that ART robotic surgery is the right prostate cancer treatment for you, we will email you information that is specially prepared to address many of the questions new patients might have. This will also include all necessary instructions and other important information related to your robotic prostatectomy. If you prefer, we can provide the information in printed form. We have a dedicated team of medical and support staff, who are committed to helping you prepare for this procedure. Learn more about preparations before your surgery
Q. What are the unforeseen complications of robotic surgery?
While robotic prostate cancer surgery is extremely safe in experienced hands, some complications are possible in any anesthesia and abdominal surgeries. These include, but are not limited, to bleeding, infection, blood clotting, heart attack, hernias, permanent urinary incontinence, impotence, and strictures. While intraoperative mortality is almost unheard off, it is possible with any anesthesia and surgery. Equipment malfunction is rare, happening in less than 0.4 percent of cases; Mount Sinai has three backup robots to address this. Learn about robotic prostate cancer surgical outcomes at Mount Sinai