Laparoscopic -- The surgeon makes several small cuts instead of one big cut. Long, thin tools are placed inside the cuts. The surgeon puts a thin tube with a video camera laparoscope inside one of the cuts. This allows the surgeon to see inside your belly during the procedure. Robotic surgery -- Sometimes, laparoscopic surgery is performed using a robotic system. The surgeon moves the instruments and camera using robotic arms while sitting at a control console near the operating table.
Not every hospital offers robotic surgery. Perineal -- Your surgeon makes a cut in the skin between your anus and the base of the scrotum the perineum. The cut is smaller than with the retropubic technique.
This type of surgery often takes less time and causes less loss of blood. However, it is harder for the surgeon to spare the nerves around the prostate or to remove nearby lymph nodes with this technique. The surgeon removes the prostate gland from the surrounding tissue.
The seminal vesicles, two small fluid-filled sacs next to your prostate, are also removed. The surgeon will take care to cause as little damage as possible to the nerves and blood vessels. The surgeon reattaches the urethra to a part of the bladder called the bladder neck. The urethra is the tube that carries urine from the bladder out through the penis. Your surgeon may also remove lymph nodes in the pelvis to check them for cancer.
A drain, called a Jackson-Pratt drain, may be left in your belly to drain extra fluid after surgery. A tube catheter is left in your urethra and bladder to drain urine.
This will stay in place for a few days to a few weeks. Why the Procedure is Performed. Risks of this procedure are: Problems controlling urine urinary incontinence Erection problems impotence Injury to the rectum Urethral stricture tightening of the urinary opening due to scar tissue.
Before the Procedure. If you smoke, you should stop several weeks before the surgery. These side effects are often temporary. However, if they are affecting your quality of life, ask your doctor about options that can help. Prostatectomy Surgery Basics At Johns Hopkins, doctors use the latest techniques to perform prostatectomies. Robotic surgery : Tiny incisions and robotic technology help doctors perform a precise, minimally invasive procedure with faster recovey time and smaller incisions.
Open surgery : This approach uses traditional incisions and tools. For more complex circumstances, an open surgery may be a more appropriate option than a robotic surgery.
During the surgery, your doctor will: Make a small incision to gain access to your prostate. Remove the prostate. Reconnect the bladder to the urethra, the tube that carries urine outside of the body. Your doctor will then insert a tube Foley catheter into the tip of your penis that extends into your bladder to drain urine during the procedure.
The location of incisions will depend on what technique your doctor uses. If you also have a hernia or bladder problem, your doctor may use the surgery as an opportunity to repair it. Once your doctor has removed the part of your prostate causing symptoms, one to two temporary drain tubes may be inserted through punctures in your skin near the surgery site.
One tube goes directly into your bladder suprapubic tube , and the other tube goes into the area where the prostate was removed pelvic drain. Make sure you understand the post-surgery steps you need to take, and any restrictions such as driving or lifting heavy things:.
Robot-assisted prostatectomy can result in reduced pain and blood loss, reduced tissue trauma, a shorter hospital stay, and a quicker recovery period than a traditional prostatectomy.
You usually can return to normal activity, with minor restrictions, around four weeks after surgery. Simple prostatectomy provides long-term relief of urinary symptoms due to an enlarged prostate. Although it's the most invasive procedure to treat an enlarged prostate, serious complications are rare. Most men who have the procedure generally don't need any follow-up treatment for their BPH.
Explore Mayo Clinic studies of tests and procedures to help prevent, detect, treat or manage conditions. Prostatectomy care at Mayo Clinic. Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. This content does not have an English version. This content does not have an Arabic version. Overview Prostatectomy is surgery to remove part or all of the prostate gland.
Explaining prostatectomy options A Mayo Clinic urologist explains prostatectomy options. Request an Appointment at Mayo Clinic. Prostatectomy incisions Open pop-up dialog box Close. Prostatectomy incisions During an open prostatectomy, one large incision is made in your abdomen left. Share on: Facebook Twitter. Show references AskMayoExpert. Radical prostatectomy adult. Mayo Clinic; Cunningham GR, et al.
Surgical treatment of benign prostatic hyperplasia. Finally the specimens are removed from the abdomen through the plastic entrapment sack and the skin incisions closed using plastic surgery techniques to minimize scarring. Abdominal incisions at one month following surgery are generally barely visible. The following is a slide show of a series of schematic drawings to help patients better understand the steps involved with nerve-sparing robotic prostatectomy.
Although most patients experience some degree of urinary leakage i. Comparison of outcomes between pure laparoscopic vs robot-assisted laparoscopic radical prostatectomy: a study of comparative effectiveness based upon validated quality of life outcomes. Br J Urol Int , Return of sexual function following nerve-sparing robotic prostatectomy is more challenging to define and assess as results depend on multiple factors including patient age, preoperative sexual function, percent of nerves spared during surgery, recovery time after surgery and presence of pre-existing medical conditions such as hypertension, heart disease, diabetes, obesity, smoking and high cholesterol.
Viagra, Cialis, Levitra at 3, 6, and 12 months postoperatively. Comparison of outcomes between purle laparoscopic vs robot-assisted laparoscopic radical prostatectomy: a study of comparative effectiveness based upon validated quality of life outcomes. As with any major surgery, complications, although rare, may occur with robotic prostatectomy. Potential risks and complications with this operation include, but are not limited to, the following:.
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