Surgery for Prostate Cancer: Robotic Radical Prostatectomy

#ProstateCancer #RoboticProstatectomy #RadicalProstatectomy
ANIMATION TRANSCRIPT: If you have prostate cancer that has not spread beyond your prostate, your doctor may recommend robotic radical prostatectomy to remove your prostate gland. The prostate is a walnut-sized gland in men just beneath your bladder. Your prostate gland surrounds your urethra, which is the tube through which urine will exit your body. The end of your large intestine, called the rectum, lies behind your prostate. Each of your seminal vesicles combines with a vas deferens to form an ejaculatory duct, which attaches to your prostate gland. Prostate cancer is an abnormal growth of cells lining the tubular gland tissue inside your prostate. As the cancer cells multiply, a tumor forms. Before your procedure, an intravenous line or IV will be started. You may be given antibiotics through the IV to decrease your chance of infection. You'll be given general anesthesia. A breathing tube will be inserted through your mouth and down your throat to help you breathe during the operation. A Foley catheter will be inserted into your bladder to drain urine. Your surgeon will make a small incision near your belly button and insert a plastic tube called a port. Carbon dioxide gas will be pumped into your abdomen through this port. The gas will inflate your abdomen, giving your surgeon more room to see and move the surgical tools. After your abdomen is inflated, a high-definition camera will be inserted into this port. Your surgeon will make additional port incisions for robotic instruments as well as for instruments used by patient-side assistants. An assistant will insert all of the robotic tools through these ports. Unlike standard laparoscopic instruments, these tools can rotate 360 degrees and have more flexibility than the human wrist. Seated at a special console, your surgeon will operate the robotic arms and the camera with joystick-like controls and foot pedals. A computer will translate the exact movements of your surgeon's fingers into precise movements of the surgical tools. At the same time, a high-definition vision system will provide a magnified, three-dimensional, stereoscopic view of the surgical area. Your surgeon will separate tissue surrounding your bladder. Using the Foley catheter as a guide, your surgeon will cut your urethra between your bladder and your prostate. Each seminal vesicle and vas deferens will be identified and separated from your bladder. Then, each vas deferens will be cut. To prevent injury to your rectum, your surgeon will separate it from the back of your prostate. To preserve sexual function, your surgeon will carefully tease away nerves and blood vessels on each side of your prostate. This nerve-sparing step is only performed if you had sexual function prior to surgery, the tumor does not extend into the nerves, and your surgeon has the necessary skill and experience. Next, your surgeon will cut your urethra at the other end of your prostate. This cut will free your prostate so that it can be removed. Lymph nodes near your prostate may also be removed to determine if your cancer has spread. Finally, your urethra will be reattached to your bladder. At the end of your procedure, the tiny incisions will be closed with stitches, staples, surgical glue, or closure tape dressings. You will have a catheter in your bladder to keep it drained. This will usually be left in place for about a week after surgery. Soon after your surgery, your breathing tube will be removed, and you'll be taken to the recovery area for monitoring. You will be given pain medication as needed. You may continue to receive antibiotics through your IV. Your bladder may be flushed intermittently with a sterile solution to wash out accumulated blood and clots. Most patients are released from the hospital the same day or one day after the procedure.
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