Frequently Asked Questions on the
Operative Technique of Da Vinci Radical
Prostatectomy
Dr R K Mishra
What is Da Vinci Radical Prostatectomy?
This is a minimally invasive major surgery of the prostate done with the smallest incision made
in the removal of the cancerous prostate gland as well as its surrounding tissues. It employs a
modern technology in the world of surgery that comes with a surgical platform equipped with
3D, high definition vision. It is also designed with miniaturized surgical instruments that
perform surgery beyond what a human hand can do. Hence, this procedure is often termed as a
“robotic” surgery. However, your doctor still has the full control of the instrument during the
entire operative procedure.
What are the advantages offered by this procedure?
With the removal of the entire prostate, there is greater chance of cure from prostate cancer.
This is considering the fact that prostate cancer is localized with no distant metastasis or
regional lymph node. The operative technique of Da Vinci Radical Prostatectomy also speeds up
the return of normal sexual and urinary function. Reports show that patients who underwent
this type of procedure have earlier return of erectile function compared to open surgery
approach. They have also resolved urinary incontinence in as fast as 6 months post operatively.
Other benefits from this type of surgery includes fast recovery, shorter hospital stay, less pain,
less blood loss, shorter period of catheter insertion required, less need to undergo blood
transfusion, lesser risks of wound infection and lesser possible complications.
How is the procedure performed?
After the anesthesia has been inducted, a carbon dioxide will be introduced the patient’s
abdomen, creating an open space to increase the surgeon’s visibility. Once enough open space
is created, the doctor will incise 6 small openings, 2 on each side and one below the umbilical
area in a downward arch position. These openings measure around ¼ – ½ inch each. Ports will
also be inserted in them to keep them open. This is where the endoscopic camera and the
surgical instruments will be inserted. Using Da Vinci’s miniature surgical instruments and video
camera, the surgeon will dissect the prostate gland as well as its adjacent tissues. The doctor
will also preserve the nerves on the patient’s prostate gland if possible. After the operation was
done, the small incisions will be closed back using bandages and sutures.
What can be expected postoperatively?
After surgery, you will wake up with a catheter attached. You will also spend a night in the
hospital to recover from the effect of anesthesia. However, expect to experience pain when the
effects of the anesthesia wear off. However, the doctor anticipates this to happen; hence an
analgesic will be prescribed beforehand. You will also slowly be allowed to assume a sitting and
standing position and be advised to walk around when you are able to. The catheter will also
stay in place for a week. Hence, you will receive instructions how to keep it functioning
properly.
Will the patient be put to bed rest a week after the operation?
The doctor will usually advise the patient to have plenty of rest. However, one will be
encouraged to walk frequently. Though others experience fast recovery, heavy lifting and
straining must still be avoided a month after the surgery. This is to ensure that the patient will
be completely healed from the operation.
World Laparoscopy Hospital
Cyber City, DLF Phase II, Gurgaon, NCR Delhi, 122 002, India
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