Robotic-assisted prostatectomy

Prostate tumors are among the most common tumors affecting men over 50 worldwide. There are different therapeutic methods for prostate cancer, including radiation, chemotherapy, hormonal therapy, and surgical therapy, which is the most important as it ensures radical prostatectomy. 

Surgical intervention was performed through traditional surgery for decades. Recently there has been a breakthrough in the treatment of prostate cancer by applying robotic surgeries for radical prostatectomy, which includes many advantages we will list in this article.   

What is a robotic surgery?
The robotic surgery is a minimally invasive technology that is used today to perform several surgical interventions. This procedure allows working through small incisions rather than large incisions, resulting in shortened recovery periods, fewer complications, and shorter hospitalization periods. The surgical robot combines the advantages of minimally invasive surgery and advanced robotic technology.

What is a robotic prostatectomy?
Now, most procedures for prostatectomy are minimally invasive surgical procedures used to remove the prostate.
The advanced robotic surgery relies on passing mini surgical tools through several small incisions in the patient's abdomen to allow the surgeon to remove the prostate and nearby tissue with great precision. This procedure is less invasive than the traditional prostatectomy, which requires a large incision in the abdomen.
Why would someone need a robotic prostatectomy?
Robotic prostatectomy is applied to treat patients with prostate cancer. Prof. Mahmoud AbdElHakim, Professor of Urology at Cairo University, discusses this procedure with all patients who need a radical prostatectomy.
What happens during robotic-assisted radical prostatectomy (RARP)?
Unlike traditional surgery, robotic surgery requires only 4-5 small incisions, through which the surgeon uses a powerful, high-resolution scope and specialized surgical tools to remove the prostate.
What is the difference between robotic-assisted and laparoscopic prostatectomy?
Both are minimally invasive techniques for the removal of prostate tumors. In a laparoscopic prostatectomy, the surgeon is just next to the patient's bed and uses the instruments with both hands. In a robotic prostatectomy, the surgeon uses an automated controller near the patient to drive the robotic arms to perform the procedure with the highest precision.

How does robotic surgery work?
Robotic-assisted radical prostatectomy works through an advanced system that allows the surgeon to work on the prostate while improving vision, control, and accuracy. The computer-assisted surgical robot system consists of three main components:
1. 3D display of the surgical field, including field depth, magnification, and high resolution. This is done through a 3D laparoscope and image-processing equipment. This display provides a magnified view of the delicate structure surrounding the prostate gland (for example, nerves, blood vessels, and muscles). This allows optimal preservation of these vital structures.
2. Instruments that simulate the movement of the hands, wrists, and fingers, allowing for a greater range of motion and greater precision.
3. The control unit that allows the surgeon to control the instruments, translating the surgeon's natural hand and wrist movements into consistent and precise motions. This makes it easier for the surgeon to accurately control the tissue and regard all angles of the prostate.
The surgical robot provides greater accuracy in moving the tools, knowing that the most important factor in the success of any surgery is the experience and skill of the surgeon, and this is what Prof. Mahmoud AbdElHakim characterizes.

Details of a robotic-assisted radical prostatectomy:
The surgeon manages a computer controller within the operating room, handling delicate wrist instruments that provide a range of motion far greater than a human wrist. The surgery is performed without the surgeon's hands entering the patient's body cavity, as the surgeon moves the robot's arms to work through several small incisions in the patient's abdomen. Finally, the prostate is removed through one of the microincisions.

How long does it take to eradicate prostate tumors with a surgical robot?
Although performing robotic prostate surgery may take approximately 2-4 hours, patients generally feel much better and experience significantly less pain in the early postoperative period.

What are the advantages of robotic prostatectomy?
This procedure is carried out through small incisions without cutting the muscles. During a radical prostatectomy, the surgical robot provides the surgeon with exceptionable-resolution images, allowing precise prostate removal. Patients also get the following benfits:
Shorter hospitalization period: Patients are usually able to return home the day after prostate surgery.
Faster recovery time: The patient can return to activities of daily living earlier, 7-10 days after surgery. Patients undergoing a traditional prostatectomy need 4-6 weeks before resuming routine activities.
Less pain: In general, patients experience less pain after robotic surgery without the need for painkillers.
Less blood loss: They also experience significantly less bleeding during the procedure with the surgical robot.
Micro incisions: Robotic prostatectomy uses very small and precise incisions, thus leaving less scarring.
Maintaining vital functions: There is no loss of sexual potency or urinary control associated with conventional surgery.

What are the possible sexual side effects of robotic-assisted radical prostatectomy?
Robotic prostate surgery is extremely accurate, ensuring an exceptional ability to avoid the nerve bundle responsible for erection; thus does not affect the erection.
Sexual function after radical prostatectomy is affected by several factors, such as the patient's age and how much sexual activity the patient had before surgery. Overall, some men experience temporary erectile dysfunction after prostatectomy.
What happens after robotic prostate surgery?
Robotic prostate surgery usually lasts 2 to 4 hours.
The average hospital stay is one to two days.
Prof. Mahmoud AbdElHakim and his medical team follow you up during your stay in the hospital. They provide you with post-surgical instructions before you return home.
Urinary catheterization is usually dispensed on the fifth day of surgery, after an x-ray examination of the bladder.
No driving for 7 days after radical prostatectomy surgery.
There are no other restrictions on the physical activities that you can do after prostatectomy.
You can proceed to take aspirin when you return to eat your meals regularly.
Viagra is given after the removal of the urinary catheter, usually 50 mg at night, and the dose may be increased to 100 mg if there is no response. Viagra is not given to induce the erection but to improve blood flow to the penis. If you have any heart conditions, you need to follow up with your physician before taking Viagra.
The first test for PSA levels is one month after prostate surgery, then three to six months later.

Robotic-assisted radical prostatectomy (RARP) is a minimally invasive procedure to remove prostate tumors. This modern technology is applied in Egypt by Prof. Mahmoud AbdElHakim, Professor of Urology, Cairo University.