Robotic Radical Prostatectomy utilizes a Da Vinci robotic device as an interface between the surgeon and the patient. It is a master-slave system whereby the surgeon controls the movements of the robotic arms to perform a minimally invasive laparoscopic radical prostatectomy. Therefore the result of the robotic surgery is COMPLETELY DEPENDANT on the skill and experience of the surgeon in controlling the movements of the robotic arms. The state-of -the- art Da Vinci robotic arms allow rotation at the joints of the instruments to mimic the movements of the human wrist. This enhances the surgeon’s range of movement and its dexterity. This in turn leads to more precise dissection of the prostate gland and its surrounding vital structures such as the neurovascular bundles (nerves responsible for erections) and urethra minimizing the risks of erectile dysfunction and urinary incontinence.
The operation is performed through six small incisions on the abdomen. A binocular telescope held by one of the robotic arms is inserted through an incision above the umbilicus to provide a magnified and 3 dimensional image of the surgical site. Because of the magnification, the view is superior to open surgery. The da Vinci technology filters the natural tremors of the human hand, therefore movements of the robotic arms within the body are precise and free of tremor. The Da Vinci system also allows extra arms within the body cavity, hence the surgeon operates with 3 arms instead of 2 arms making the operation easier. The surgeon sits down and looks into the console to do the operation hence there is less fatigue The assistant is scrubbed and changes instruments as requested by the surgeon.
The advantages of a robotic prostatectomy are minimal blood loss therefore less risk of a blood transfusion (0-1%), better anastomosis between urethra and bladder (less stricture rate), lower complication, lower infections, better cosmesis, quicker convalescence and less pain (usually mobile the next day), less narcotic analgesic requirement (usually oral pain killers), quicker discharge and return to activities of daily living, equivalent or improved cancer control to open surgery, earlier return to urinary control (less continence pads) and earlier return to sexual function in bilateral nerve sparing surgeries.