Robotic prostatectomy

MEDICAL ANIMATION TRANSCRIPT: If you have prostate cancer that has not spread beyond your prostate, your doctor may recommend robotic radical prostatectomy to remove the prostate gland. The prostate is a walnut-sized gland in men. Just below your bladder, your prostate gland surrounds the urethra, which is a tube through which urine leaves your body. The final end of your large intestine, called the rectum, is behind the prostate. Each of your seminal vesicles combines with a vas deferens to form an ejaculatory duct that joins your prostate gland. Prostate cancer is an abnormal growth of the cells lining the tubular glandular tissue inside your prostate. As the cancer cells multiply, a tumor forms. Before the procedure, an intravenous (IV) line will be inserted. You may receive IV antibiotics to decrease the chance of infection. You will be given general anesthesia. A breathing tube will be inserted through your mouth and into your windpipe to help you breathe during the operation. A Foley catheter will be inserted into your bladder to drain urine. Your surgeon will make a small incision near your navel and insert a plastic tube called a port. Carbon dioxide will be pumped into your abdomen through this port. The gas will inflate your abdomen, giving the surgeon more room to see and move surgical instruments. After your abdomen is inflated, a high-definition camera will be inserted into this port. Your surgeon will make additional incisions in the port for robotic instruments, as well as for instruments used by assistants at your side. An assistant will insert all the robotic tools through these ports. Unlike standard laparoscopic instruments, these tools can rotate 360° and have greater flexibility than the human wrist. Seated at a special console, your surgeon will operate the robotic arms and camera using joystick controls and foot pedals. A computer will translate the exact movements of your surgeon's fingers into precise movements of the surgical tools. At the same time, a high-definition vision system will provide an enhanced, three-dimensional stereoscopic view of the surgical area. Your surgeon will separate tissue around your bladder. Using a Foley catheter as a guide, your surgeon will cut your urethra between your bladder and prostate. Each seminal vesicle and vas deferens will be identified and separated from your bladder. Then, each vas deferens will be cut. To prevent injury to your rectum, your surgeon will separate it from the back of your prostate. To preserve your sexual function, your surgeon will carefully separate the nerves from the blood vessels on each side of your prostate. This nerve-preserving step is only performed if you had sexual function before surgery, the tumor has not spread to the nerves, and the surgeon has the necessary skill and experience. Next, your surgeon will cut your urethra at the other end of your prostate. This cut will free your prostate so that it can be removed. The lymph nodes near your prostate may also be removed to determine if your cancer has spread. Finally, your urethra will be reattached to your bladder. At the end of the procedure, the small incisions will be closed with sutures, staples, surgical glue, or closure dressings. You will have a catheter in your bladder to keep it drained. This will usually be left in place for about a week after surgery. Shortly after surgery, your breathing tube will be removed, and you will be taken to the recovery area for monitoring. You will be given pain medication if needed. You may continue to receive antibiotics intravenously. A sterile solution will be intermittently placed in your bladder to flush out any accumulated blood clots. Most patients are discharged from the hospital the same day or the day after the procedure.