DaVinci prostate surgery
Using the unique da Vinci robotic system, surgeons perform minimally invasive and highly effective actions to remove the prostate gland and affected tissues. Compared to conventional prostate surgery, robot-assisted prostate gland removal does not cause postoperative complications and does not require a long recovery.
Many patients with prostate cancer or benign prostate gland enlargement are searching for a modern surgical solution. Specialists achieve good results using new technology - da Vinci robot-assisted prostate surgery. The equipment allows the doctor to perform painlessly and efficiently prostate gland operations. In addition, it has been clinically tested and proven to be highly effective.
The da Vinci robot performs minimally invasive cuts and sutures, replacing the surgeon's actions. Efficient technologies help doctors conduct surgery more accurately and have fewer complications afterwards. In addition, the technique has a proven statistic to reduce the risk associated with traditional surgery, complications, etc.
Traditional approaches like TURP or open surgery have many complications related to erection, nerve damage, urination and cosmetic defects. On the contrary robotic surgery eliminates such side effects. It is commonly called nerve sparing da Vinci surgery, meaning that surgical actions are so gentle that they preserve nerve functions and lead to better outcomes.
A detailed description of robotic prostate surgery
The da Vinci system is not a robot that performs the procedure alone. Instead, it is a high-precision surgical device that, guided by an experienced surgeon, supports the precise and millimetre-precise procedure performance. The doctor controls the machine.
The "surgical robot" consists of 2 components — the control console operated by a surgeon and the multi-armed surgical assistant positioned on the patient. The specialist must continuously use the control console manually. In addition to precise actions, the device is equipped with high-resolution cameras that allow seeing beyond normal surgeon vision.
Independent actions of the "robot" or automatic process programming are impossible. Instead, the surgeon controls the devices using two unique handles. The surgical assistant implements the surgeon's commands and movements on the control console. Patients should understand that the technique aims to help urologists have better control during the surgery but doesn't substitute the surgical skills of a doctor.
The approach is commonly used in prostate cancer and benign prostatic hyperplasia (BPH). However, it's not limited to the gland only and can be applied when the tumour has penetrated the organ. More detailed information about robotic prostate resection is available in our treatment guide.
Who is the right candidate for DaVinci?
Most people with prostate cancer are candidates for robotic surgery. However, the course of prostate treatment is individual for each patient. In general, results from robotic radical prostatectomy are best when the prostate malignancy is in stages I-II. However, there are some other indications for da Vinci surgery:
- Benign prostatic hyperplasia;
- Acute prostatitis with the formation of phlegmon or abscesses in the pelvis;
- Chronic prostatitis;
- Prostatitis with the formation of stones in the gland;
- Severe stages of prostate hyperplasia.
There is a common misconception between patients and urologists that patients should have localized lesions in the prostate gland to have a successful intervention. However, a prostate tumour that grows into the gland's capsule or metastasizes to the regional lymph nodes can also be removed using the da Vinci robot. In addition, numerous studies have proved that non-localized prostate cancer operated by robot-assisted radical prostatectomy (RARP) has better survival and reduced risks.
Benefits of using robotic surgery
The advantages of robot-assisted surgical procedures are less blood loss, less pain, faster wound healing and overall better recovery due to the minimally invasive approach. In addition, patients have better long-term outcomes regarding potential side effects. For example, complete urinary continence is restored more frequently and quickly with the da Vinci operation. In addition, men who have not previously had erection problems regain their ability to have an erectile function more rapidly than after open surgery.
A surgeon can work with great precision thanks to the 10x magnification and the three-dimensional display on the control console. In contrast to people, surgical instruments always work absolutely without shaking and are therefore accurate to millimetres.
Some studies have shown that patients after da Vinci surgery have fewer chances of being readmitted to the hospital than traditional prostate surgery. In addition, many doctors state that hospitalization is shorter thanks to gentle cuts and faster healing.
Complications and side effects
Robotic-assisted prostatectomy lowers the risk of certain complications, but they're still possible. For example, there is still a chance of nerve damage and compression. In addition, in the case of detection of any difficulties that prevent the course of the operation, there may be a need to perform an open procedure. Similarly to traditional surgeries, the technique has general surgical risks:
- damage to neighbouring organs;
- urinary incontinence (substantially decreased).
Urologists are used to managing such risks and providing patients with the best possible outcome. However, it is worth mentioning that doctors report probable longer surgery due to system installation and individual settings for each patient.
Recovery and aftercare after da Vinci surgery
Immediately after the operation, the patient rests in the recovery room. The doctor prescribes painkillers and conventional symptomatic treatment (anti-inflammatory, anti-vomiting) if necessary. Also, the patient may have some swelling in the scrotum and penis after surgery, which will resolve with time. Recovery after robotic prostatectomy is fast and effective:
- Patients return erectile function;
- Patients who have used da Vinci robotic treatment are more likely to be cured of cancer. They have a much lower risk of recurrence of malignant tumours;
- Rapid recovery of health and return to everyday life;
- Urination normalizes within two-six months after the operation.
Usually, patients spend 2-4 days in the clinic. Urologist follow-up the patient for 1-2 weeks to ensure no long-term complications. Many people are curious about going to the gym after the surgery. Doctors are concluded that patients should gradually return to sports starting from 50% activity in 2 weeks with a total capacity in 4-6 weeks.
Is robotic prostate removal better than an open approach?
The da Vinci robot leads to a faster healing process for the patients than after an open operation:
- There is less blood loss;
- The wounds heal quicker;
- Cuts are a maximum of two cm in size.
Compared to open surgery, the advantage for surgeons is the better overview and more precise control of the instruments. Cleaning image technology allows organs and tools to be displayed spatially and enlarged. In addition, the robot is significantly more accurate than a surgeon who only works with their hands.
What is the success rate of DaVinci prostate surgery?
The overall biochemical recurrence-free (PSA level<0.1 ng/mL) survival was 95% at a mean follow-up of 9.7 months. There was complete continence at 3 and 6 months in 89% and 95% of patients, respectively. The life expectancy of men treated with a robotic da Vinci system exceeds ten years.
How long does robot-assisted prostate surgery take?
A doctor puts the patient under anaesthesia for the duration of the procedure, usually two to four hours. The final surgery duration depends on the state of the disease and can be slightly longer in the case surrounding tissues should be removed.
How long does it take to recover from robotic surgery?
The length of hospital stay following robotic prostatectomy is generally one day. However, certain situations may require a more extended hospital stay. With robotic-assisted surgery, the recovery time lasts about 2-3 weeks.
How many clinics have the da Vinci system?
The da Vinci robotic system is still the latest technology and remains unavailable in many countries. In most clinics, the number of robots is insufficient to provide medical care to all patients with prostate cancer, or there are none at all. Currently, around 2,000 clinics are equipped with da Vinci robots.
Where can I get DaVinci prostate surgery?
What are the best clinics for DaVinci prostate surgery?
Who are the best doctors for DaVinci prostate surgery?
Prof. Dr. med. Jurgen Gschwend from University Hospital rechts der Isar Munich
Prof. Dr. med. Martin Kriegmair from Urological Clinic Munich-Planegg
Prof. Dr. med. Sebastian Wille from Beta Clinic Bonn
Prof. Dr. med. Felix K. H. Chun, MA, FEBU from University Hospital Frankfurt am Main of Goethe-University
Prof. Dr. med. Mark Schrader from Helios Hospital Berlin-Buch
The price range of da Vinci surgery
In different clinics, the cost may vary depending on the package of services, the amount of medical care provided and additional examinations. On average, the price of robotic prostate gland removal varies between 13,500 $ - 38,000 $. The primary factors influencing the cost are the stage of the disease and the doctor's skill. The cost usually includes:
- Preliminary consultation;
- Examinations (urogenital and pelvis ultrasound, prostate MRI scan)
- Hospitalisation 7 days (planned) with accommodation in a comfortable room. If necessary, prolongation of hospitalisation until complete stabilisation;
- Da Vinci robot-assisted prostate surgery under general anaesthesia;
- Postoperative examinations;
- Required medications and materials;
- Regular doctor visits, medical supervision 24 hours a day;
- Histological analysis of the material taken during the operation;
- Follow-up recommendations.
In some hospitals, the final bill can be at a high point. As a result, world-renowned clinics and leading urologists might charge significantly more for their service. Patients should understand that surgeons who performed 50 robotic surgeries can't be equal to the specialist with 500 da Vinci surgeries behind.