Robotic Surgery Solves Two Key Concerns for Prostate Patient

Prostate cancer is one of the most common types of cancer in men. Symptoms of prostate cancer, which starts to occur especially after the 50s and progresses insidiously, usually manifest in the late stages of the disease. Robotic surgery, which provides significant comfort to patients and surgeons, stands out in the treatment in recent years. "da Vinci" robotic surgery, which is the most advanced technology reached by surgery, provides a comfortable healing process without creating a surgical incision in the body and improves the quality of life of the patient. From Memorial Ankara Hospital Urology Department Prof. Dr. Ali Fuat Atmaca gave information about robotic surgery applications in prostate cancer.

As you get older, prostate problems begin to emerge.

The prostate is an 18-20 grams gland located just below the urinary bladder in men and surrounding this part of the urinary tract, whose main function is related to reproduction. Benign growths, inflammatory diseases such as chronic or acute prostatitis or prostate cancer may develop in the prostate, which begins to cause problems especially with age progression. The presence of prostate cancer in the family, that is, in the first degree, increases this risk significantly. It is also seen that prostate cancer is more common in African Americans. However, there are studies showing that tobacco use, obesity and predominantly animal fat feeding are also risk factors.

It's not showing any symptoms in the early stages!

Unfortunately, prostate cancer does not show symptoms unless it reaches very advanced stages and these symptoms predominantly occur in the future. It is often not possible to distinguish early symptoms of prostate cancer from benign prostate growth. However, when local or distant spread is observed in the advanced stages of cancer, that is, metastasis, symptoms such as inability to urinate, obstruction of kidney canals and bone pain may occur due to obstruction of bladder output.

Inspection and PSA testing are of great importance for diagnosis

The diagnosis of prostate cancer is made by finger rectal examination and biopsy performed after PSA (Prostate Specific Antigen) test in the blood. Although obtaining suspicious results in the examinations is one of the most important findings, it does not necessarily mean that there is cancer. Because PSA is not a cancer-specific test, but a prostate-specific test. This value may also increase in benign growth of the prostate or inflammatory diseases. Findings such as stiffness and irregularity observed in rectal examination with fingers also raise doubts in terms of prostate cancer. In line with the findings, there are two options for patients.

Either a direct ultrasound-guided prostate biopsy or a newer technique, Multiparametric Prostate MRI, should be used to evaluate the prostate and a biopsy should be performed on the suspected area or areas using a method called "Fusion Biopsy".

Robotic surgery rapidly improves

Surgery is the most important treatment of bladder cancer that has not metastasized, that is, has not spread to distant regions. Surgery has three different methods: open, laparoscopic and robotic surgery. While open or laparoscopic surgeries are performed according to the situation, they have been preferred more in recent years due to the advantages of robotic surgery.

Minimizes the risk of nerve and vascular damage

In prostate surgery performed with robotic surgery, 5 small incisions are made in the patient's abdomen. Tubes called trocars are attached to the holes formed in these incision areas. Robot arms are attached to the pipes and the camera and surgical instruments of the robot are placed within these arms to obtain a three-dimensional image with high quality and 10-20 times magnification. With robotic arms with advanced mobility, the cancerous prostate is removed by preserving the structure called the vascular-nerve package, which has been shown to have an effect on both protecting sexual dysfunction and preventing urinary incontinence. Thus, it is aimed to eliminate the risk of urinary incontinence and loss of sexual function.

Robotic surgery is also used in prostate cancer surgeries that have metastasized

Advantages of robotic surgery:

• The mobility of the robotic arms provides a significant advantage in surgery with its 3D image and the ability to magnify the image,
• Blood loss is less than open surgery. Therefore, blood transfusions are often not required.
• Since closed surgery is performed, the postoperative pain of the patient is less and is usually discharged within two days.
• The connection of the urinary bladder and the urinary tract is performed perfectly and the catheter placed in the urinary tract can be removed within a week.
• Urinary incontinence and penile erection problems may occur after open or laparoscopic prostate surgeries. In prostate cancer surgeries performed with Da Vinci Robotic Surgery technique, thanks to the "Nerve protection" technique, the male nerves and urinary retention muscles are better protected and the risk of these problems that may adversely affect the patient's quality of life is minimized.
• While previously, prostate cancer patients with metastasis in the lymph nodes and bones were not operated, today, lymph nodes are successfully removed with robotic surgery in the lymph nodes and in patients with a limited number of (less than 3 or 5) bone spreads. This is important in terms of the patient's life comfort and duration.

Prepared by the Medical Editorial Board. Our health library contents have been prepared for informational purposes only and with the scientific content on the registration date. For all your questions, concerns, diagnosis or treatment about your health, please consult your doctor or health institution.