Surgery remains a primary option for many men with localized prostate cancer. A radical prostatectomy is the surgical removal of the entire prostate, the seminal vesicles, the tissue immediately surrounding them, and some of their associated pelvic lymph nodes. There are several methods in which a radical prostatectomy can be performed.
- Open Radical Prostatectomy:
There are two different surgical techniques in performing an open radical prostatectomy. Using the retropubic approach, the prostate is removed through an incision in the lower abdomen. In this approach, the prostate gland can be removed (generally with limited blood loss and preservation of the neurovascular bundles, which are responsible for maintaining erectile function). With the perineal approach, the prostate is removed through an incision between the anus and the scrotum. Bleeding problems are less common with the perineal approach. A smaller incision and generally less pain are experienced with this approach.
- Minimally Invasive Robotic-Assisted Surgery:
With recent advances in minimally invasive surgery and computer technology, the prostate gland can now be removed through several one- to two-inch incisions in the patient’s abdomen. In a robotic prostatectomy, a surgeon operates a surgical robotic system—a device that holds surgical instruments and a laparoscopic camera to remove the prostate gland through laparoscopic access.
- Minimally Invasive Laparoscopic Surgery:
Radical prostatectomy can be performed in a manner similar to the robotic-assisted radical prostatectomy using laparoscopic instruments that are guided directly by the surgeon instead of the robotic arms.
As with all operations, there may be complications of radical prostatectomy; some occurring early and some late. Bleeding can occur in any major operation. Long-term complications after surgery may include urinary incontinence and erectile dysfunction. Short-term incontinence after radical prostatectomy is common.
- Radical Prostatectomy • Stanley Brosman, MD 2003
- Long Term Results of Surgery for Localized PC PDF • Stanley Brosman, MD 2010
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- Nerve Sparing Robotic Prostatectomy -Update • Ashutosh Tewari, MD 2007
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- Advanced Robotic Technique videos on Robotic Prostatectomy – NY Presbyterian / Weill Cornell
- Robotic Prostatectomy FAQs – City of Hope