Robotic-Assisted Radical Prostatectomy

Prostate Cancer Overview
The prostate gland, located just below the bladder and in front of the rectum, plays a key role in the male reproductive system. About the size of a walnut, it encircles a section of the urethra (the tube that carries urine from the bladder) and contains cells that make some of the seminal fluid, which protects and nourishes the sperm.

Although the prostate contains several types of cells, almost all prostate cancer starts in the gland cells. Usually, this type of prostate cancer (called adenocarcinoma) grows slowly, but sometimes it can grow and spread quickly.

According to the American Cancer Society (ACS), prostate cancer is the most common non-skin malignancy found in men. The ACS estimates that approximately 218,890 men will be diagnosed with prostate cancer — and about 27,050 men will die of the disease — in 2007. Although one man in six will develop prostate cancer in his lifetime, only one in 34 will die from the disease.

Surgery and Other Treatment Options
Treatment options for prostate cancer include surgery, radiation therapy, hormone therapy and watchful waiting. Surgery, or radical prostatectomy, involves removing the prostate as well as some surrounding tissue. It is the most widely used treatment for men under 70 years of age with cancer confined to the prostate.¹

The main goal of prostatectomy is to remove the cancer. Secondary goals are to preserve urinary function and erectile function. A nerve-sparing prostatectomy attempts to preserve nerves running alongside the prostate so that the patient may be able to return to his prior erectile function.

Laparoscopic and Robotic Radical Prostatectomy
Laparoscopic techniques* have been developed in the past 10 years as an alternative to open, nerve-sparing radical prostatectomy. The advantages of this minimally invasive surgery include less pain, blood loss and scarring; a shorter recovery time; and a quicker return to normal daily activities.

Robotic-assisted radical prostatectomy — a minimally invasive surgery that makes use of the da Vinci® robotic system — offers several advantages for the surgeon including improved visualization, additional degrees of freedom of motion and improved ergonomics (design that enables the surgeon to work with greater ease).² Overall, the robotic system allows surgeons to operate with precision and control using only a few small incisions.

The use of robotic and laparoscopic radical prostatectomy has enabled urologic surgeons to reduce morbidity while maintaining the excellent treatment outcomes of radical prostatectomy. Intermediate cancer outcomes appear similar to radical prostatectomy with good functional results.³

Washington University Urologists who perform Robotic-Assisted Radical Prostatectomy.

	Above, components of the da Vinci® S Surgical System. Below, the System's EndoWrist® moves like a surgeon's hands. Photos courtesy of Intuitive Surgical, Inc.

Washington University Urologists Who Perform Robotic-Assisted Radical Prostatectomy:

• Sam B. Bhayani, M.D.
• Adam S. Kibel, M.D.
  

To make an appointment, please call (314) 362-8200.

*Methods using an endoscope that is inserted through an incision in the abdominal wall to visualize anatomy.

1. “Prostate Cancer Surgery.” National Prostate Cancer Coalition. On previous Web site "www.fightprostatecancer.org." Accessed on 6/26/07. Current Web page on treatment is http://www.zerocancer.org/site/PageServer?pagename=APC_Treatment
2. Grubb III RL, Vardi IY, Bhayani SB, Kibel AS. “Minimally Invasive Approaches to Localized Prostate Carcinoma.” In: Oh WK (ed.). Hematology/Oncology Clinics of North America. Volume 20, Issue 4. Elsevier; 2006; pp. 887-888.
3. Grubb III RL, Vardi IY, Bhayani SB, Kibel AS. “Minimally Invasive Approaches to Localized Prostate Carcinoma.” In: Oh WK (ed.). Hematology/Oncology Clinics of North America. Volume 20, Issue 4. Elsevier; 2006; pp. 891-892.