Robotic prostatectomy is offered by urologists at UCLA as a treatment approach for patients with early stage prostate cancer. It offers a minimally invasive treatment with less blood loss and a more rapid overall recovery. The robotically-assisted laparoscopic prostatectomy is performed at UCLA Urology by Karim Chamie, MD, MSHS, Arnold Chin, MD, PhD, Mark S. Litwin, MD, MPH, Robert Reiter, MD, and Chris Saigal, MD, MPH using the da Vinci robot.
A robotically assisted procedure puts the advantages of minimally invasive surgery in the hands of skilled UCLA cancer surgeons who have a wealth of experience in treating prostate cancer through open surgery. These tools allow them to apply their skills in successfully treating prostate cancer in a minimally invasive procedure while sparing nerves to preserve potency and sparing continence to preserve urinary control. The robotically assisted procedure is performed using five or six keyhole incisions, and offers the advantages of reduced blood loss, reduced pain, shorter hospital stays and a significantly faster recovery. Robotic tools offer freedom of motion that is similar to that of the human hand; an improvement over the traditional laparoscopic tools. They can also scale their motions to achieve much more precise and fine movements without tremor. Visualization is improved with a more mobile camera system that provides a three-dimensional view.
UCLA Urology robotic surgeons have been offering outpatient prostatectomy since 2011 for appropriate patients. Men are discharged to home the same day of surgery instead of remaining in the hospital overnight, as is customary. Same-day surgery for prostate cancer is made possible by the extremely low risk of bleeding and need for blood transfusions (<1%), as well as the low degree of pain associated with robotic surgery. Men usually return to their physician’s office the morning after surgery for a routine check and within one week to remove either a urethral or suprapubic tube that drains the bladder following surgery (so called urethral catheterless surgery). UCLA Urology surgeons also no longer use abdominal drains in appropriate patients following this surgery, reducing discomfort and bother associated with the surgery. Outpatient, or same-day, prostatectomy is particularly suited for young men without any prior health conditions.
Same-day Robotic-assisted Prostatectomy at UCLA >
Other surgical procedures may be performed on men with advanced or recurrent prostate cancer disease. For these men, in addition to removing the prostate gland, the lymph nodes in the area of the prostate may be removed either before or during the same operation. UCLA offers both standard lymph node removals as well as what is termed “extended lymph node dissection” for men with a high-risk of nodal involvement. This is done to determine if the prostate cancer has spread to the lymph nodes.
A nerve-sparing radical prostatectomy is ultimately designed to preserve a man's sexual function. The success rate in preserving sexual potency is dependent on a few factors - a man's age, the quality of his erection prior to the surgery, and the surgeon's skill and experience in protecting and preserving the nerves during the Prostate nerve-sparing operation. Nerve-sparing Technique: step-by-step guide >
The UCLA Department of Urology collaborated with the Department of Surgery to open the Center for Advanced Surgical and Interventional Technology (CASIT) in 2002. The Center promotes clinical, educational and research use of surgical robots and digital imaging in surgery and medicine. Using a robotic surgical system, urologists at UCLA are able to perform operations more precisely than ever before. The system filters the surgeon's hand tremors and allows better range of motion, which ultimately will narrow the deviation in surgical skill among surgeons and result in less discomfort and quicker recovery times for patients. Faculty members in the Department of Urology are also training other surgeons in minimally invasive surgery. CASIT website >
The robotic system was originally developed by the Department of Defense for use as a robotic surgeon for the battlefield and is approved by the FDA. The system replicates the surgeon's hand movements realtime in laparoscopic instruments. It cannot be programmed, nor does it make any independent decisions, but rather it does only what the surgeon inputs in realtime.