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Robotic Surgery To Treat Early Prostate Cancer

Overview

Prostate cancer develops in the outer part of the prostate gland and in the later stages, can spread outside the prostate into the lymph nodes and sometimes, into the bones

 What is prostate?

The prostate is a walnut-sized gland all around the urethra (pipe to bring out urine) and is present in all men. The main function of the prostate is to produce secretions which form an integral part of the semen and help in nourishing the sperms in the semen and has a reproductive function. As it is around the urethra, enlargement of prostate predominantly produces urinary related symptoms.

What are the types of prostate enlargement?

Most men after 50 years of age have some degree of prostate enlargement which is called BPH (Benign Prostatic Hypertrophy). However, a small number of patients develop prostate cancer and this can be evaluated by doing a blood test called PSA (Prostate Specific Antigen). In patients with elevated PSA, an MRI Scan and/or Prostate Biopsy are done to confirm.

What is prostate cancer?

Prostate cancer develops in the outer part of the prostate gland and in the later stages, can spread outside the prostate into the Lymph nodes and sometimes, into the bones. Prostate cancer that is limited to the prostate gland with no spread outside is called Early Prostate cancer and is curable at this stage. The treatment options available in this stage are surgical removal of the prostate or Radiotherapy.

What is prostate removal?

This has traditionally been done with the open operation and with a big incision in the lower abdomen. However, the advent of minimally invasive (keyhole) procedures has made this procedure less morbid and has hastened the recovery from surgery. The technique of minimally invasive procedure (laparoscopic removal) has been modified with the advent of the surgical robot and robotic removal of the prostate has now made the procedure not only precise but also reduced the complications associated with the earlier techniques.

What is the surgical Robot?

The surgical robot now in use is called ‘Da Vinci Robot’. It is a misconception that the robot does the procedure. In fact, specially designed instruments are attached to the robotic arms and these are moved by the surgeon sitting at the console. The procedure is done by the surgeon with the assistance of the robot.

Why and when of Robotic Surgery?

The traditional, open way of doing surgery is associated with a larger cut and produces more pain and more delay in recovery. The minimally invasive procedures are less painful and result in speedier recovery with little or no discomfort for the patient. The addition of robotic assistance to the laparoscopic procedure has made it safer due to the magnification and the three-dimensional view of the field of surgery. In addition, procedure-related complications like urine leakage and problems with sexual function recover faster after Robotic Surgery compared to the traditional laparoscopic procedure.

Robotic removal of the prostate is ideal for patients with early localized prostate cancer and those who are fit to withstand the procedure. This is the choice of treatment worldwide for early prostate cancer and has been extensively used in the USA and is now available at quite a few centres in India.

Dr. K Subrahmanyam,

MS MCh (Uro), DNB (Uro) FRCS,

Sr. Consultant Urologist, Transplant & Robotic Surgeon,

Apollo Hospitals, Jubilee Hills

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