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Urology and Robotic Surgery

When medication and other non-surgical treatments are either unavailable or cannot relieve symptoms, surgery is the accepted treatment for a broad range of conditions that affect the male reproductive organs and the organs of the urinary tract. These conditions include, but are not limited to, prostate cancer, ureteropelvic junction (UPJ) obstruction, bladder and kidney cancer, and vesicoureteral reflux.

Facing any kind of urologic surgery creates a great deal of anxiety for most men. Among your concerns is: "Will my body function normally following surgery?" Traditional open urologic surgery—in which large incisions are made to access the pelvic organs—has been the standard approach when surgery is warranted. Yet common drawbacks of this procedure include significant post-surgical pain, a lengthy recovery, and an unpredictable, potentially long-term impact on continence and sexual function.

Fortunately, less invasive surgical options are available to many patients facing urologic surgery. The most common of these is laparoscopy, which uses small incisions. While laparoscopy can be very effective for many routine procedures, limitations of this technology prevent its use for more complex urologic surgeries. A new category of surgery is being used by an increasing number of surgeons worldwide for prostatectomy and other urologic procedures. This minimally invasive approach, utilizing the latest in surgical and robotics technologies, is ideal for delicate urologic surgery. This includes prostatectomy, in which the target site is not only tightly confined but also surrounded by nerves affecting urinary control and sexual function. Your surgeon now has a better tool to spare surrounding nerves, which may enhance both your recovery experience and clinical outcomes.

For specific information on a procedure, click one of the links below. For a referral to a skilled robotic surgeon at Suburban Hospital, call 301-896-3939 or visit the Contact Us page.

 

 

Prostatectomy

The gold standard treatment option for men under 70 with early-stage, organ-confined cancer is surgical removal of the prostate using nerve-sparing radical prostatectomy. Prostatectomy is also the most widely used treatment for prostate cancer today in the US.

The primary goal of prostatectomy is removal of the cancer. A secondary goal is to preserve urinary function and—when applicable—erectile function. Preservation of the nerves necessary for erections can be an extremely important goal for patients. These nerves run alongside the prostate and are often damaged when removing the prostate. A nerve-sparing prostatectomy attempts to preserve these nerves so that the patient may be able to return to his prior erectile function.

Types of Prostatectomy

Approaches to this procedure include traditional open surgery, conventional laparoscopic surgery, or robotic prostatectomy, which is a laparoscopic surgery.

With a traditional open procedure, your surgeon uses an 8-10 inch incision to access the prostate. This approach often results in substantial blood loss, a lengthy, uncomfortable recovery, and a risk of impotence and incontinence.

Conventional laparoscopy uses a specialized surgical camera and rigid instruments to access and remove the prostate using a series of small incisions. This approach provides your surgeon with better visualization than an open approach. In addition, it provides patients the benefits of a minimally invasive procedure.

Despite these advantages, conventional laparoscopy relies on rigid instruments and standard 2D video, technical limitations that can be challenging for the surgeon. Because of these drawbacks, conventional laparoscopy doesn't lend itself well to complex procedures like prostatectomy. Therefore, very few urologists use this approach for prostatectomy. Moreover, neither laparoscopy nor open surgery can provide adequate visualization for a very precise, nerve-sparing prostatectomy.

 

Robotic Prostatectomy

Referred to by many as robotic surgery for prostate cancer or robotic prostatectomy, the robotic prostatectomy is more a minimally invasive surgery that is quickly becoming the preferred treatment for removal of the prostate following early diagnosis of prostate cancer. In fact, studies suggest that robotic prostatectomy may be the most effective, least invasive prostate surgery performed today.


Open Surgical Incision                    Robotic-Assisted Incision

Though any diagnosis of cancer can be traumatic, the good news is that if your doctor recommends prostate surgery, the cancer was probably caught early. And, with robotic prostatectomy, the likelihood of a complete recovery from prostate cancer without long-term side effects is, for most patients, better than it has ever been.

Recent studies suggest that robotic prostatectomy offer improved cancer control and a faster return to potency and continence. Robotic prostatectomy may also offer these potential benefits:

  • Significantly less pain
  • Less blood loss
  • Fewer complications
  • Less scarring
  • A shorter hospital stay
  • And a faster return to normal daily activities

 

Kidney Cancer

Kidney Cancer can form in the small tubes inside the kidney. Those tubes located in the center of the kidney where urine collects, are used to filter blood. Each year in the United States, kidney cancer is diagnosed in about 54,000 Americans and more than 13,000 do not survive the disease. Kidney cancer is slightly more common in men and is usually diagnosed between the ages of 50 and 70 years. The most common kidney cancer is called renal cell carcinoma.

It is important to realize that with early diagnosis and treatment, kidney cancer can be cured. If found early, the survival rate for patients with kidney cancer ranges from 79 to 100 percent.

Treatment Options

Kidney cancer is fairly resistant to radiation and chemotherapy. As a result, the gold standard treatment for localized kidney cancer is removal of the kidney or kidney tumors.

Kidney surgery is traditionally performed using an open approach, meaning doctors must make a large incision in the abdomen. Another approach is conventional laparoscopy. It is less invasive, but limits the doctor's dexterity, vision and control, compared to open surgery.

Kidney Conditions

If your doctor recommends surgery for kidney cancer, you may be a candidate for a minimally invasive approach using robotic-assisted technology.  In many cases it offers several potential benefits over conventional open surgery, including:

  • Significantly less pain
  • Less blood loss
  • Fewer transfusions
  • Less risk of infection
  • Less scarring
  • Shorter hospital stay
  • Shorter recovery time
  • Increased potential for kidney preservation in certain prescribed cancer operations
  • Better clinical outcomes, in many cases

Robotic for kidney cancer incorporates the best techniques of open surgery and applies them to a minimally invasive approach.

The precision and dexterity of the robot's advanced instrumentation facilitates a minimally invasive approach for treating kidney cancer.