Robotic surgery for urologic conditions

Urology as a surgical treats diseases of the male and female urinary tract and the male reproductive organs. The urinary tract, which begins within your kidneys, helps the body get rid of waste. Urologists treat patients of all ages who are dealing with problems affecting the bladder, kidneys and prostate gland.

Many urologic problems can be treated without surgery. However, if prescription drugs or other medical therapies do not help, your doctor may recommend surgery.

Some common urologic conditions that often require surgery include enlarged prostate (known as benign prostatic hyperplasia), prostatitis, prostate cancer, kidney obstructions (known as uretero-pelvic junction obstruction), urinary incontinence and diseases of the bladder.

Benign prostatic hyperplasia

As a man ages, it is common for the prostate gland to become enlarged. Doctors call this condition benign prostatic hyperplasia (BPH). An enlarged prostate can restrict the flow of urine and lead to gradual loss of bladder function. Symptoms of BPH include difficulty starting and stopping the urinary stream, the need to urinate two or more times at night and a weak, interrupted flow. If untreated, BPH can lead to more complications including bladder stones and infection.

Learn more about benign prostatic hyperplasia.

Prostatitis

Prostatitis is swelling and irritation of the prostate gland. The inflammation can develop rapidly (acute bacterial prostatitis) or start slowly and continue for a long period. Men age 50 or older who have an enlarged prostate are at risk for prostatitis related to urinary tract infections.

Learn more about prostatis.

Urinary incontinence

Urinary incontinence is leakage of urine from your urethra, the tube that carries urine from the bladder out of the body. Problems with urine control can range from occasional leakage to the complete inability to hold any urine.

Learn more about urinary incontinence.

Physicians at United Hospital trained to perform robotic surgery for prostate and urologic conditions

• Todd D. Brandt, MD
• Robert A. Gaertner, MD
• Christopher J. Knoedler, MD
• Peter D. Sershon, MD

The procedure

During robotic surgery, the surgeon sits at a console a few feet from the patient and another member of the surgical staff stands at the operating table with four, jointed robotic arms overhead. The surgeon makes several small incisions, and inserts a tiny camera and miniature surgical instruments through the openings. The camera provides a detailed view of the pelvic cavity on a color monitor, while the robotic arms work with great precision at the surgeon’s command.

The surgeon controls every delicate movement of the micro-instruments at all times. Using this advanced technology, surgeons can now handle a wider range of cases, and carry out even the most complex procedures with improved accuracy and very little damage to surrounding tissue.

Robotic surgery vs. traditional open surgery

For many years, doctors have successfully treated urologic conditions with surgery. Some problems required open abdominal surgery and others were managed with traditional laparoscopic surgery.

Until recently open surgery was the only choice for complex procedures like prostatectomy (complete or partial removal of the prostate to treat prostate cancer or enlarged prostate), kidney obstruction and nephrectomy (surgical treatment for kidney cancer).

Open surgery requires a large incision – through skin, muscles and sometimes bone – to reach organs and maneuver surgical instruments. There is usually considerable blood loss and patients spend several days in the hospital. It often takes many weeks to recover and side effects can vary.

Robotic surgery is an advanced minimally invasive surgery that offers an innovative alternative to open surgery and traditional laparoscopic surgery. It allows surgeons to perform complex maneuvers with more precision and control than standard laparoscopy.

The da Vinci Surgical System includes a special 3D camera that provides a magnified view 10 times greater than the power of the human eye. This improved vision and control can give surgeons a means to remove only cancerous tumors and leave the rest of the organ intact. Surgeons operate through tiny incisions, which results in less blood loss, shorter hospital stays and a quicker recovery.

Today robotic surgery is dramatically reducing risks and improving the outcomes for patients who need surgery for a urologic condition. The da Vinci system uses the best techniques of open surgery and applies them to a robotic-assisted, minimally invasive approach. Even patients who were unable to have open surgery or traditional laparoscopic surgery for various reasons may be candidates for robotic surgery.

If you have a urologic condition that requires surgery, ask your doctor if robotic surgery might be an option for you.

Benefits of robotic surgery

Robotic surgery is transforming the field of urology. It is rapidly becoming the preferred method to treat many urologic conditions. Compared to traditional open surgery, robotic assisted surgery provides significant benefits and excellent results for most patients. Because every surgery and every patient is unique, outcomes and benefits will vary. Ask your doctor if robotic surgery is an option for you.

Benefits include:

• Shorter hospital stay
• Less pain and pain medication
• Decreased risk of infection
• Minimal loss of blood
• Smaller incisions and less scarring
• Faster and easier recovery
• Reduced risk for urinary incontinence and impotence
• Increased potential for kidney preservation in certain cancer operations

How robotic surgery compares

The table below compares three surgical options for urologic conditions. The patient outcomes clearly demonstrate the benefits of choosing da Vinci robotic-assisted surgery.

Data provided by Intuitive Surgical. For more information on this topic, please visit www.davincisurgery.com.

Patient stories

Prostate: Removing the prostate robotically/simple prostatectomy

Lee Burke knew he needed surgery for his enlarged prostate gland. It wasn’t cancer, but the gland’s size and continued growth was interfering with his ability to urinate and began affecting his kidneys.