Robot-Assisted Laparoscopic Prostatectomy

Prostate cancer is the second leading cause of cancer-related death in American men. When diagnosed and treated early, it is highly curable.

The Comprehensive Cancer Center at Wake Forest Baptist Medical Center in Winston-Salem, NC, is a National Cancer Institute-designated Prostate Cancer Center of Excellence. This offers patients access to specialty-trained urologists, radiation oncologists, medical oncologists and clinical trials to provide patients with the best treatment for their particular form of prostate cancer.

Hemal Ashok KAshok K. Hemal, MD, director of the Robotic and Minimally Invasive Urologic Surgery Program at Wake Forest Baptist, and one of the surgeons who has pioneered urologic robotic surgery throughout the world, performs a robot-assisted laparoscopic radical prostatectomy.

The prostate gland is in a delicate location in the male reproductive system just below the urinary bladder and is surrounded by important nerves for sexual function. Surgical removal of the prostate (radical prostatectomy) is one of the treatment options for early-stage prostate cancer. Surgical removal requires great care to maximize the chance for cure and to preserve continence and sexual function.

The technique of robotic-assisted laparoscopic radical prostatectomy is a less invasive method for removal of the prostate, resulting in less blood loss and quicker recovery as compared to the traditional open surgery. It also has excellent functional outcome. The robotic assistance allows use of centimeter-sized, wristed instruments in a 3-dimensional view with 10-fold magnification in a narrow space, where the prostate is located.

Hemal has been closely associated with developing the initial surgical protocols currently used by most urologists performing robotic surgery.

About Wake Forest Baptist Medical Center: Wake Forest Baptist is an academic health system comprised of North Carolina Baptist Hospital and Wake Forest School of Medicine. It is licensed to operate 1,154 acute care, psychiatric, rehabilitation and long-term care beds.

About the Procedure: While prostate cancer is the second most common type of cancer in American men and the second leading cause of cancer death in men, it is highly curable when diagnosed and treated early. The risk of early-stage prostate tumors is wide ranging – some are fast growing and require aggressive measures while others are slow growing and pose minimal threat, adding to the importance of thorough and accurate diagnosis.

For many men with early-stage prostate cancer, robotic-assisted laparoscopic radical prostatectomy has emerged as an attractive option among the surgical alternatives, according to Ashok K. Hemal, MD, professor of urology and director of the Robotic and Minimally Invasive Urologic Surgery Program at Wake Forest Baptist Medical Center. The program is made up of 10 specialty trained urologists who perform robotic and minimally invasive surgery for a wide range of urologic problems (kidney, ureter, bladder, urethra, and reproductive organs) in adults and children.

Hemal, one of the surgeons who has pioneered urologic robotic surgery throughout the world, has performed hundreds of these operations for a variety of urological diseases of the prostate, kidney, and bladder. He is achieving results equivalent to the traditional open surgical approach, but with less blood loss, fewer complications and shorter recuperation times.

The prostate gland is in a delicate location in the male reproductive system just below the urinary bladder and is surrounded by important nerves for sexual function. Surgical removal of the prostate (radical prostatectomy) is one of the treatment options for early-stage prostate cancer. Surgical removal requires great care to maximize the chance for cure and to preserve continence and sexual function.

The technique of robot-assisted laparoscopic radical prostatectomy is a less invasive method for removal of the prostate, resulting in a quicker recovery compared to the traditional open surgery and an excellent functional outcome. The robotic assistance allows use of centimeter-sized, tiny wristed instruments in 3-dimensional view with 10-fold magnification in a narrow space, where the prostate is located.

The robot-assisted laparoscopic radical prostatectomy capitalizes on the latest computer technology. Surgeons make approximately five small incisions or key holes into the patient’s abdomen through which robotic and laparoscopic ports are inserted. Through these ports, a lighted camera and robotic instruments are inserted. The surgeon operates the robot sitting at a console away from the patient. A camera gives the surgeon a view inside the body of the patient that is three dimensional and has a 10-15 fold magnification.

The surgeon’s surgical movements are transferred to the surgical field allowing the robot’s miniaturized instruments to remove the cancerous prostate, while preserving nerves and continence mechanisms. The assisting surgeon helps in changing various robotic instruments inserted in the ports and to hold back organs to make room for the tiny instruments so that they may perform their delicate movements deep within the pelvis of the patient.

Numerous studies of the robot assisted laparoscopic prostatectomy have shown excellent outcomes. “The ability to achieve goals that may be often better than conventional surgery in removing cancer and preserving sexual function and urinary continence makes this modality an attractive alternative for many localized prostate cancer patients,” said Hemal.

Hemal will perform the robot-assisted laparoscopic radical prostatectomy on a live webcast and will demonstrate this operation. Hemal has been closely associated with developing the initial surgical protocols currently used by most urologists performing robotic surgery.

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Wake Forest Baptist physicians are experts in a wide variety of urologic conditions.

Last Updated: 07-17-2014
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