What is Radical Prostatectomy?

Radical prostatectomy is one of the primary treatment options for prostate cancer. It involves complete removal of the prostate gland followed by reconnecting the urethra and bladder.

Possible postoperative discomforts and complications include wound pain, discomfort from catheter placement, urinary leakage, blood transfusion, wound infection, stricture at the urethra-bladder junction, intestinal obstruction, and intestinal injury.

Traditionally, radical prostatectomy involves open abdominal surgery, resulting in a large incision, complicated surgery, and slow recovery.

However, in the past decade, with the advent of robotic surgery systems, radical prostatectomy can be performed through a few small incisions in the abdomen. Precise tissue dissection and reconstruction of the urinary tract are performed during the surgery, significantly reducing the likelihood and severity of discomfort and complications mentioned above, leading to a faster recovery.

“EXTRAPERITONEAL” Da Vinci Robotic assisted laparoscopic radical prostatectomy

Generally, robotic assisted radical prostatectomy involves entering the abdominal cavity and insufflating surgical gas before proceeding with prostatectomy.

However, robotic assisted radical prostatectomy does not necessarily require entering the abdominal cavity for prostate removal.

The “extraperitoneal” da Vinci robotic assisted radical prostatectomy, as the name suggests, does not enter the abdominal cavity during surgery, nor does it insufflate surgical gas into the abdominal cavity.

Theoretical advantages include:

1. In extraperitoneal surgery, since no gas is insufflated into the abdominal cavity, the blood and water during surgery do not irritate the intestines, theoretically leading to a faster postoperative gastrointestinal recovery, allowing for the resumption of eating when hungry.

2. Although rare, if there is leakage at the junction of the urethra and bladder after surgery, urine will not flow into the abdominal cavity, reducing the risk of peritonitis.

3. Similarly, although rare, the probability of accidentally injuring intra-abdominal organs is minimized.

4. Patients with a history of abdominal surgery or obesity may face increased difficulty with abdominal surgery. Extraperitoneal surgery can overcome this issue.

However, it should be emphasized that whether performed transperitoneally or extraperitoneally, robotic assisted radical prostatectomy is quite safe, mature, and routine. Both approaches are comparable in terms of cancer treatment efficacy, preservation of urinary and sexual functions, and occurrence of postoperative complications.

Your doctor will choose the most suitable surgical approach based on your condition.

Dr. Wu’s Experience

According to Dr. Wu’s experience, compared to transperitoneal radical prostatectomy, the main advantage of extraperitoneal radical prostatectomy is a rapid recovery:

Patients operated on by Dr. Wu typically start eating normally on the night of or the day after surgery.

The drainage tube is usually removed on the third day after surgery, reducing pain.

Conclusion:

Robotic assisted radical prostatectomy is a mature procedure, and patients often recover quickly postoperatively. The extraperitoneal approach offers some theoretical advantages, and doctors will choose the most suitable surgical method based on the patient’s condition."

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