Frequently Asked Questions
What are the potential advantages of robotic prostatectomy?
Results with traditional open radical retropubic prostatectomy have steadily improved over time. At Boston Medical Center, we have completed more than 1,000 open prostatectomies through a mini-laparotomy incision, extending from the pubic bone upwards about half-way to the belly-button. Cancer control rates, and recovery of potency and continence are excellent in most patients. Our early experience with robotic prostatectomy suggests that these outcomes are at least equaled with robotic surgery, with less postoperative pain, reduced blood loss and a more rapid recovery for the patient. After robotic prostatectomy, patients are often walking and eating on the evening of the day of surgery, and are routinely discharged the next morning, after breakfast. The urinary catheter is removed after 7-10 days, and many patients return to work shortly thereafter.
What are the potential drawbacks of robotic prostatectomy?
At Boston Medical Center we have had excellent long term results with regard to cancer control, potency and continence recovery following traditional open prostatectomy. It is clear now from several studies that successful outcomes after prostate cancer surgery are directly related to the skill of the surgeon, including the specific techniques utilized and the volume of cases performed. Robotic technology allows surgeons skilled in open prostatectomy to perform the same operation utilizing minimally invasive techniques. Prostate cancer surgeons who have demonstrated excellent cancer control and quality of life outcomes in their patients can use the daVinci robot system to translate these excellent results into their patients operated using this minimally invasive technology. However, the daVinci system will not automatically improve the outcomes of less experienced surgeons. At Boston Medical Center, we have learned that proper patient selection is important in achieving excellent outcomes. Not every patient is a good candidate for robotic prostatectomy and currently 20% of our patients, after a comprehensive evaluation, are recommended to undergo the standard open radical retropubic approach.
Who are good candidates for robotic prostatectomy?
Patients who are of normal weight, without extensive prior abdominal surgery or radiation therapy, and with a less extensive cancer burden in the prostate are considered strong candidates for robotically assisted prostate surgery. However, even patients who don’t meet those criteria have good options for treatment of localized prostate cancer. We try and tailor treatment for each individual patient that matches each unique circumstance. A consultation with a Boston Medical Center urologist can help you determine if you are a candidate for robotic prostatectomy.