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 da VinciTM To view this video on the robotic assisted laparoscopic prostatectomy click here.
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Robotic Assisted Laparoscopic Prostatectomy Prostate cancer is the second most common cancer in men, after skin cancer, in the United States. Guillonneau and Vallancien in 1999, from France, popularized the laparoscopic approach by describing their modifications to the original technique. However, the technical demands of the surgery prevented its widespread use by the average urologist.
The next significant advance in the surgical treatment of localized prostate cancer was the development of the da Vinci robot.
Dr. Jamison Jaffe and Dr. Justin Harmon both completed a fellowship in minimally invasive urologic surgery, under the direction of Dr. Vallancien, and perform robotic surgery at Hahnemann University Hospital. Benefits of the robotic and laparoscopic procedure compared to the standard open radical prostatectomy
The robotic techniques have several advantages over the laparoscopic technique for performing radical prostatectomy.
What to Expect: Before, During and After Robotic-Assisted Laparoscopic Prostatectomy Before Surgery During Surgery There is always a risk of bleeding, infection, or injury to adjacent tissue. However, one of the major benefits of minimally invasive/laparoscopic surgery is that it tends to greatly reduce these risks. The special side effects associated with prostatectomy, post-surgical incontinence (inability to control the urge to urinate) and impotence (inability to have an erection), also apply to laparoscopic prostatectomy. After Surgery Any post-operative pain you experience will be controlled by traditional pain medications. Robotic prostatectomy does result in less post-operative pain than traditional prostatectomy. You may also feel nauseous for several hours after the surgery, which is a possible side effect of the anesthesia. Medication can also control this. You may have bladder spasms - a moderate cramping sensation in the lower abdomen or bladder - a side effect of a prostatectomy. They will decrease over time and can be treated by medication if needed. During the surgery, a Foley catheter will be inserted into your penis to drain your bladder. The catheter is generally removed a week after surgery. Generally, robotic prostatectomy enables patients to have the catheter removed sooner than traditional surgery. Your nurse will teach you on how to care for the catheter before discharge. You will be shown how to attach it to your legs to allow you to walk without difficulty. You will also have a pelvic drain placed during surgery. It drains the pelvic space around the bladder and is usually removed before discharge. Other post-operative conditions are similar to those for any major surgery. You'll have an intravenous (IV) line (a small tube put into a vein, through which you can be given fluids and medicines). At first you will be placed on a clear liquid diet and later advanced to regular foods. You may feel tired for several weeks. Prior to your discharge, you will be given necessary prescriptions and instructions, including when to follow up with your doctor. |
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This is a system consisting of a 4-armed robot connected to a remote surgeon console. The surgeon operates the system while seated at the console. A 3-dimensional display provides a unique depiction of the surgical field not previously incorporated in other systems. The first reported robot-assisted laparoscopic prostatectomy using the da Vinci system was described in 2001. This technique is gaining widespread acceptance both in the United States and Europe. It encompasses the advantages of other minimally invasive techniques.