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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. But Burke was concerned about the surgical side effects, such as loss of bladder control and erectile dysfunction, and was putting off the procedure. Then he heard about robotic surgery for his condition and sought out Peter Sershon, MD, of Metro Urology in St. Paul, the director of the Minnesota Robotic Surgery Center at United Hospital.

    "The use of robotic-assisted surgery is transforming medicine," said Dr. Sershon. "Mr. Burke was one of the first patients in Minnesota to have a simple prostatectomy, the removal of the middle portion of the prostate, with the da VinciĀ® Surgical System. He now has normal urinary and kidney functions."

    The prostate is a male reproductive gland that surrounds the urethra, the tube through which urine passes out of the body. A normal prostate weighs about 30 grams. Burke's was 150 grams, or five times larger than normal. Although the causes of prostate enlargement are not known, risk increases with age, family history and ethnic background.

    Symptoms include:

    • Dribbling at the end of urinating
    • Difficulty urinating
    • Incomplete emptying of the bladder
    • Incontinence
    • Needing to urinate two or more times per night
    • Pain with urination or bloody urine
    • Slowed or delayed start of the urinary stream
    • Straining to urinate
    • Strong and sudden urge to urinate
    • Weak urine stream
    • Urinary tract infections

    Not all men with benign prostate disease have symptoms. For some, however, symptoms can interfere with their quality of life and may lead to loss of bladder function, recurrent infections, bladder stones, urinary incontinence, and even kidney failure. When symptoms are severe and the prostate is too large for other treatment options, then surgical removal of the middle of the prostate is recommended.

    In traditional open surgery, the surgeon makes one large incision to remove the middle of the prostate. With the da Vinci device, the surgeon makes several, small incisions, through which is fed a tiny camera and special surgical tools. The camera sends images back to the surgeon who can view them on a 3D monitor. The surgeon then can make surgical decisions based on what is shown and send these decisions back through the device to be carried out.

    According to Dr Sershon, the benefits of robotic surgery over traditional open surgery are the improved ability to precisely remove the obstruction and reconstruct the prostate. There is significant reduction in side effects of the surgery, including less blood loss, pain, hospitalization and recovery time. The robotic version of this operation is now considered the "gold standard".

    Since his procedure, Burke has been able to return to all his previous activities, including working as an information technologist at 3M and boating.

    "I made myself miserable for a long time, too long. Hindsight being 20/20, I now wish I'd done it sooner," said Burke. "This surgery was the right thing to do, and I'm very happy with the results."