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Prostate cancer: Robotic surgery


Robotic radical prostatectomy

What is the Da Vinci robot?

The Da Vinci Robot is a highly advanced surgical system that uses robotic technology to assist surgeons in medical procedures. Its main advantage lies in the precision and dexterity it provides to the surgeon, allowing increased three-dimensional vision and extremely precise finger maneuverability. By using remote control consoles, surgeons can perform interventions with much less invasive movements.

Cirugía de Próstata - Robot Da Vinci

For patients, this translates into significant benefits, such as faster recovery due to smaller incisions, less postoperative pain, and a reduction in potential complications. In addition, the Da Vinci Robot allows difficult-to-access anatomical areas to be addressed more efficiently, which can be especially beneficial in complex surgeries such as the prostate. In short, this surgical system improves the patient experience by combining the surgeon’s experience with the precision and advanced technology of the robot.

What is robotic radical prostatectomy?

Robotic radical prostatectomy is a surgical procedure designed to eliminate prostate cancer. To do this, the urologist uses a robot-assisted surgical system to precisely remove the prostate.

Robot Da Vinci - Cirugía de Próstata
During surgery, the surgeon makes small incisions and controls the Da Vinci Robot from a remote console. This system provides detailed three-dimensional vision and precise surgical tools, allowing the surgeon to perform delicate movements with greater accuracy.

Advantages for patients include faster recovery and less postoperative pain since the incisions are smaller compared to traditional techniques. Additionally, robotic radical prostatectomy tends to reduce the risk of complications, such as damage to the surrounding nerves that control erectile function and urinary continence.

In the following video you can see schematically what robot-assisted radical prostatectomy consists of:

En el siguiente video puedes visualizar de forma esquemática en qué consiste la prostatectomía radical asistida por robot: 

Am I a candidate for a robotic radical prostatectomy?

In very general terms, the indications for robotic prostate surgery do not differ from those for open or laparoscopic radical prostatectomy. That is, patients with organ-confined cancer, with significant biological activity and a life expectancy greater than 10 years. However, each case is different and must be previously evaluated by a urologist with experience in prostate cancer.

Among the relative contraindications we would find: previous pelvic surgical procedures due to perforation of the hollow viscus and peritonitis, pelvic oncological surgery or radiotherapy at that level. Situations that increase the complexity of the procedure may be severe obesity (body mass index > 40), previous transurethral or retropubic prostate surgery, voluminous prostates (> 100 grams), asymmetric growth or generous middle lobe or patients with narrow and previous hormonal blockade.

Before surgery, what should I know?

In general terms, after an uneventful surgery, the patient can be discharged within the first 24-72 hours. Generally it will be done with a urinary catheter that will remain in place for 5 to 10 days. After surgery you should take into account:

  1. Treatment Options: Before robotic surgery, it is essential that the patient understands all available treatment options. This includes surgery, radiation therapy, hormonal therapies and active surveillance, where the cancer is monitored closely without immediate intervention. A calm and detailed discussion will help the patient make an informed decision based on the specific situation and her personal preferences.
  2. Risks and benefits: Knowing the risks and benefits of robotic surgery is crucial. Although robotic surgery usually has benefits such as faster recovery, less blood loss, and less time in the hospital, there are still risks, such as infections, bleeding, and side effects. Understanding these aspects will allow the patient to make conscious decisions about their treatment.
  3. Preparation for surgery: Before surgery, it is important to follow the instructions of the medical team to prepare adequately. This may include restrictions on food or medication intake, as well as specific guidelines on physical activity. Following these instructions will contribute to a safer procedure and a more effective recovery.
  4. Recovery: Recovery after robotic surgery is generally faster than with traditional techniques, but it is still essential to understand the possible side effects. These may include temporary discomfort, changes in erectile function or urinary continence. Having realistic expectations and following postoperative recommendations will help minimize any negative impact on quality of life. These recommendations vary according to the clinical profile of each patient and therefore it is important to discuss it in advance with your urologist.
  5. Postoperative follow-up: After surgery, regular medical check-ups will be scheduled to monitor recovery and evaluate the effectiveness of treatment. These appointments are opportunities to discuss any concerns or questions that may arise during the recovery process.
  6. Lifestyle changes: The importance of lifestyle changes, such as maintaining a balanced diet and engaging in regular physical activity, can be discussed. These changes can promote recovery and improve the patient’s overall health in the long term. Guidance on how to incorporate these changes into daily life will be beneficial for a successful recovery.

After surgery, what should I know?

In general terms, after an uneventful surgery, the patient can be discharged within the first 24-72 hours. Generally it will be done with a urinary catheter that will remain in place for 5 to 10 days. After surgery you should take into account:

  1. Symptom monitoring: The presence of symptoms such as unusual bleeding, fever, persistent pain or urinary difficulties should be immediately reported to the medical team for rapid and appropriate evaluation.
  2. Pain Management: Effective pain management is essential for a comfortable recovery. Understanding the prescribed medication, following the guidelines, and reporting any side effects or concerns to the medical team will ensure effective pain management.
  3. Incision care: They are small, and following the instructions for their care minimizes the risk of infection and promotes optimal healing. Keeping incisions clean and dry is essential to avoid complications.
  4. Physical activity and rest: Gradually returning to physical activity under medical guidance is essential to avoid injury and allow for effective recovery. Balancing activity with adequate periods of rest is key to a complete recovery.
  5. Rehabilitation and Kegel exercises: Generally, immediate urinary incontinence (to a variable degree) occurs, which in most cases is temporary. Participating in recommended Kegel exercises strengthens the pelvic floor muscles, improving bladder control and overall recovery. In some cases, physical rehabilitation may be recommended to optimize muscle function and reduce incontinence time.
  6. Sexual function: It is important to understand that erectile function can be affected. Openly discussing concerns with the medical team allows you to explore options such as medications or sexual therapy to improve sexual function and quality of life. Sometimes prior oral treatment may be indicated to optimize postoperative recovery.
  7. Emotional support: Recognizing and addressing any emotional concerns is essential. Seeking support from family, friends, or mental health professionals can help manage the emotional stress that can accompany the recovery process.
  8. Healthy lifestyle: Adopting a balanced diet and engaging in regular physical activity contribute not only to a faster recovery, but also to an overall improvement in quality of life in the long term. Maintaining healthy habits supports physical and emotional health after robotic radical prostatectomy.

What complications can this surgery have?

It is important that patients are informed about possible complications associated with robotic radical prostatectomy. Although it is not common to experience these problems, it is essential to be aware of them:

  1. Infection: There is a risk of infection in the surgical incisions or the surrounding area. By following postoperative care guidelines and reporting any signs of infection to the medical team, these risks can be minimized.
  2. Bleeding: Although blood loss is usually minimal with robotic surgery, in some cases bleeding may occur and even require a transfusion.
  3. Urinary problems: Temporary urinary incontinence is common after prostatectomy. Practicing Kegel exercises and following your medical team’s instructions can help improve bladder control and reduce incontinence time.
  4. Erectile dysfunction: Erectile function may be affected after surgery. Discussing available options, such as medications or sexual therapy, with your medical team can help address this.
  5. Intestinal or bladder complications: In rare cases, there may be complications related to nearby organs, such as the intestine or bladder. These complications may require additional medical intervention.
  6. Urethral stricture: The formation of strictures in the urethra is a possible complication. Additional treatment may be required if significant urinary flow problems are experienced.
  7. Hernia: Although rare, the formation of a hernia in the incision area is a possible complication. Notifying the medical team of any abdominal bulges or discomfort is essential.
  8. Reactions to anesthesia: Complications associated with anesthesia, such as allergic reactions or breathing problems, are possible. It is important to inform the medical team of any unusual symptoms after surgery.


It is critical that patients discuss these potential complications with their medical team prior to surgery and be prepared to address any concerns that may arise during the recovery process.

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