A robotic prostatectomy, also called a robotic-assisted laparoscopic radical prostatectomy, is when doctors use a special machine, or robot, to remove a person’s prostate. This is a type of keyhole surgery.

Prostate cancer is the fifth most common cause of cancer-related death in males.

This article looks at robotic prostatectomies, an important treatment method for prostate cancer. It details what happens during the procedure, how to prepare, and what a person can expect during recovery.

It also explains how effective the procedure is and how much it might cost.

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Prostate cancer develops when cells within the prostate grow and spread in an uncontrolled way. Over time, these cancer cells may spread to other body parts beyond the prostate.

According to the American Cancer Society (ACS), doctors mainly use robotic prostatectomies when the person’s prostate cancer has not spread. The aim is to cure the cancer by removing the prostate.

However, research suggests that robotic prostatectomies can also be useful for people whose cancer has spread. This is because the procedure can slow the rate of cancer growth.

A robotic prostatectomy is one treatment option for those with prostate cancer. They may also require additional treatments, such as:

According to Cancer Research UK, two machines are in the operating room during a robotic prostatectomy — the patient and control units.

The patient unit has four arms, one holding a camera and the others holding surgical tools. The control unit controls the patient unit.

The procedure generally involves the following steps:

  1. Healthcare professionals give the person a general anesthetic.
  2. The person lies on the operating table near the patient unit.
  3. The surgeon makes 5–6 small incisions in the individual’s abdomen for the camera and surgical tools to go through.
  4. Using the control unit, the surgeon guides the robotic arms to perform the surgery.
  5. They move the bladder out of the way before carefully drawing out the prostate through the incisions in the abdomen.

According to a 2018 paper, a person may need to prepare for the procedure by:

  • eating a healthy diet
  • walking 1–2 miles per day if they lead a sedentary lifestyle
  • quitting smoking, if applicable
  • reaching a moderate weight, if necessary
  • performing kegel exercises three times per day

A healthcare professional may also suggest taking nightly, low doses of phosphodiesterase inhibitors to address postoperative erectile dysfunction.

Doctors will place the individual under general anesthesia for the surgery.

Because of potential surgical complications, doctors generally recommend preoperative sperm perseveration to individuals who may wish to have children later.

Cancer Research UK notes that it can take 6–8 weeks for a person to resume their usual activities after surgery for prostate cancer.

Robotic prostatectomy requires less recovery time than open surgery. A person can usually leave the hospital within 24–48 hours after the surgery, with most discharged within 24 hours.

A person will require a urinary catheter in the days after the procedure. They may have difficulty controlling their urine. However, this is usually temporary.

People will also experience pain for the first week or so. A doctor can prescribe pain relievers to help ease this. It is also normal to feel tired for some time after the surgery.

A person’s healthcare team will provide advice and guidance on how to care for the wounds at home and when to come back for a follow-up appointment.

A 2021 literature review notes that a radical prostatectomy seems to be an effective treatment option for prostate cancer.

For example, in one study involving tumors confined to the prostate gland, 15-year cancer-free survival was 95%. However, a significant number of these people experienced urinary incontinence or erectile dysfunction after surgery.

The authors note that robotic-assisted laparoscopic radical prostatectomies may be as effective as open radical prostatectomies, which involve removing the prostate without the assistance of robotic technology.

Regardless of the method, removing the prostate can lead to urinary incontinence, which may take several weeks or months to resolve. In some cases, people require lifelong treatment.

Erections require the existence of some nerves that are close to the prostate. In some cases, when prostate cancer grows very close to these nerves, doctors have no choice but to remove them. This may cause a degree of erectile dysfunction that could last for up to 2 years.

Other effects of removing the prostate include:

According to the ACS, robotic prostatectomies are like any other surgery in that they come with certain risks.

These include:

The ACS states that there is evidence that robotic prostatectomies cause less pain and blood loss than other forms of prostatectomy.

There is no fixed cost for robot-assisted prostatectomies. However, a 2016 review suggests the average cost of this procedure was $11,878.

Medicare and Medicaid may cover some of this cost.

A person can get financial help or advice from the following organizations:

During a robotic prostatectomy, surgeons will remove a person’s prostate with the help of a machine. They control robotic arms to remove the prostate carefully.

Although robotic prostatectomies can result in less bleeding and less recovery time than open surgery, the risk of erectile dysfunction and other complications remains the same as other methods of prostate removal.

Prostate cancer resources

Visit our dedicated hub for more research-backed information and in-depth resources on prostate cancer.

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