Steps for robotic prostatectomy

Welcome to the RoboSurge Center, which specializes in robotic surgeries. The robotic surgery is the latest technology in oncology treatment. It provides the highest levels of accuracy and safety to ensure surgical control of tumors through its 4K three-dimensional magnified vision, which has a magnification rate of up to 20 times.

The robot also allows the surgeon to control all surgical devices and imaging tools, as the surgeon is the only controller during the surgery.

Why was the robot chosen to treat your condition? 

After reviewing your X-rays and blood tests and excluding tumor spread, a prostatectomy is now available. So the aim is now to control the disease by completely and radically eradicating it. This guarantees you the shortest path to healing in one session. 

The robot's real addition compared to traditional methods is the sustainable outcome. In addition to the first goal (tumor resection), sustainable results and side effects control become our next goals.

The microscopic view of nerves, arteries, veins, and valves is the secret of maintaining urine control and restoring erectile function and sexual ability.

So the selection of a surgical robot for your case is an indication that you can get disease control results without side effects.

The treatment journey begins immediately after the diagnosis. There are precautions before the procedure, steps to be followed, and post-surgical instructions.

After diagnosing the presence of a prostate tumor through the rectal ultrasound and biopsy, the antibiotic is stopped immediately after taking the samples. In the light of biopsy analysis, other tests, such as nuclear scanning are requested in the case of rapidly spreading tumors with a high-risk rate. Investigations are also performed to ensure the safety of various body functions. 

After that, we check the integrity of the heart muscle with the specialist doctor and reorganize any medications, whether for fluidity or pressure. Finally, an anesthesiologist clarifies all procedures and precautions. 

Admission appointments are set up, typically on the morning of the procedure. fasting from eating and drinking from the previous night (within 6 hours before the procedure) is required, except for chronic medications like hypertension and diabetic medications, which are taken with a minimum amount of water on the morning of the surgery. You must bring all reports and x-rays.

Following admission, the urologist and anesthesiologist evaluate you, review the reports, check that you have fasted, and check your vital signs. Typically, the procedure takes place two to three hours following admission.

After entering the operating room, the necessary preparations for anesthesia begin by giving you simple anesthesia to insert an anesthetic catheter, which is used to supply some post-surgical medications. The anesthesiologist then applies general anesthesia, which takes 45 to 60 minutes.

- The surgery is performed through 5 incisions of 8 mm in the abdominal wall. The robot is a mediator between the surgeon’s hand and the highly accurate devices, with the surgeon handling the controller unit to directly control the surgical tools.

- Because the robot used in oncology surgeries is not programmed to work without driving and there is no software for self-control, the device cannot function without the surgeon's full control.

- Nerves and valves are controlled using specialized scissors, bipolar dissecting machines, and surgical staplers.

- The surgery takes about 2-3 hours and ensures your safety because there is no need for blood transfusions or big surgical wounds.

- After extracting the resected part, a urinary catheter and a drain are installed inside a sterile surgical bag at one of the laparoscopic openings, after making a 5-7 cm incision. 

- Samples are sent for pathological re-analysis by the hospital or your companions.

Fourth: The end of the procedure:  

- You will be first sent to the recovery area, where you spend about an hour until the full assurance of regaining consciousness, the absence of pain, and checking your vital signs. 

- You will be subsequently moved to your room under the supervision of nursing staff who are specially trained to handle these surgeries.

- You will spend about 24 to 48 hours in the hospital till complete reassurance about bowel movement and gastric emptying.

- Antibiotics and fluids are administered subcutaneously. The dosage of both is calculated according to your weight.

- Healthy, low-fat food and many vegetables are suggested. Water consumption regularly is also advised.

- The urine catheter continues and is not removed until after a week.

-  A temperature increase for not more than 1/2 degree.

- Light pink blood in the catheter in the first 3 days after the surgery. 

- Urge to urinate despite having a urine catheter in place.

- Some urine leakage from outside the catheter. 

Contact RoboSurge center for a consultation if these symptoms recur more frequently than a simple rate or any other symptoms not previously stated, allowing the doctor to decide whether or not an examination is necessary.

A week after hospital discharge, the surgeon removes the catheter and follows up on the analysis report of the samples and the resected parts. Your follow-up plan is described as follows:

- Follow-up on PSA testing

- Urine control monitoring.

- Monitor erections and sexual abilities.

After the catheter removal, you can return to work, taking into account:

- After removing the catheter, wash and shower normally, but avoid putting water directly on the wounds for the first 10 days.

- Not carrying heavy things, no excessive going up and down stairs, and not walking long distances for more than 10 minutes in the first week.

- Exercising normally one month after the procedure.

In 80% of cases, urine control returns within the first week of the treatment, though it is typical for this period to last up to a month. This is because the patient's age and the size of the prostate directly correlate with the return of normal urine control.

After the first three months, the erection returns to its pre-surgical state (if the erectile nerves are not sacrificed in advanced tumors, as the patient is notified before the procedure).

Additionally, the recovery of an erection is directly correlated with the patient's age, prostate size, and disease severity.

Radiation and hormonal therapy are limited to the following cases: 

- The appearance of active cells in the lymph nodes. 

- The appearance of active cells in the seminal vesicles. 

- High PSA after the surgery. 

- The severity of the disease, according to Gleason's score, has increased to 4 + 4 = 8 or more.

The multidisciplinary team (MDT) takes the decision after at least one month has passed.

We send our best wishes for a quick recovery.