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Robot-assisted laparoscopic radical prostatectomy
If you have been diagnosed with prostate cancer, one of the treatment options you may be considering is Radical Prostatectomy, or surgical removal of the prostate. This procedure probably offers the best chance of complete cure, although it is not appropriate for everybody (for example, if the cancer is shown by an MRI or bone scan to have spread beyond the prostate).
As with all forms of treatment for prostate cancer, it can cause unwanted side-effects such as erectile dysfunction (impotence) or incontinence; however you can minimise these risks by choosing an experienced surgeon who uses the nerve-sparing technique and who has performed large numbers of these operations.
Laparoscopic Radical Prostatectomy is a relatively new way of removing the prostate by using 4-6 small perforations (keyhole surgery) rather than one longer incision (open surgery). During the past year, the Prostate Centre team has undertaken a programme at The London Clinic, using the latest Da Vinci robotic technology to enhance this laparoscopic technique.
The robot does not perform the operation. Its movements are controlled by the surgeon, who is seated in the same room but away from the patient and is able to carry out precise and controlled movements using tiny, 7mm instruments at the end of the robotic arms. These instruments have a 360° range of movement and can be manipulated intricately because of the powerful magnification and 3-dimensional view that the surgeon has at the console. They dissect the delicate structures, eliminating the tremor associated with traditional laparoscopy.
The benefits compared with open prostate surgery may include reduced risk of sexual dysfunction and incontinence due to better visualisation of the anatomy. In addition, there is less scarring, much less blood loss and less pain, leading to a shorter hospital stay, faster removal of catheter, quicker recovery and return to normal activities.
This robotic technology was developed nearly ten years ago in the USA, where there are now over 350 robots in use. In the UK, there are currently only six (four of them in the NHS) and very few surgeons able to perform the technique.
The robot used by The Prostate Centre team is housed in a purpose-built operating theatre at The London Clinic, London’s premier private hospital.
Professor Roger Kirby, who has performed over 1200 open radical prostatectomy operations, has now performed over 300 robotic cases and has carried out more in the past year than any other surgeon in the UK.
Working with him as part of the team are consultant urological surgeons Mr Prokar Dasgupta and Mr Chris Anderson, who have skills in other robotic procedures and laparoscopic surgery respectively. You may choose to have your operation performed by any one, or a combination of these experienced surgeons.
Dr Peter Amoroso, who as anaesthetist has worked alongside Professor Kirby for over ten years, is involved in our patients’ pre-operative preparation as well as looking after them during and after the procedure He runs a programme of fitness optimisation which can bring significant benefits in terms of their tolerance of surgery, their recovery and ongoing lifestyle change.
Robot-Assisted Laparoscopic Radical Prostatectomy is approved by NICE (The National Institute for Clinical Excellence). It is accepted by all the major health insurance companies, who recognize the positive benefits of this technique. Providing your policy allows treatment at The London Clinic, in most cases it should cover the cost of the hospital charges in full. The surgeon’s and anesthetist’s fees are eligible for benefit, although you should be aware that some companies will not cover the full amount of these fees and that you will be responsible for the shortfall. If you do not have health insurance and have to fund your treatment yourself, we will be happy to discuss the costs with you.
If you would like further information or wish to make an appointment to see one of our Prostate Centre specialists, please contact us.