completeness or appropriateness for a particular purpose.
This page provides our patients with some frequently asked questions regarding Laparoscopic Radical Prostatectomy, one of the newer procedures for the treatment of prostate cancer.
What is a Laparoscopic Radical Prostatectomy?
Radical Prostatectomy is the complete surgical removal
of the prostate and seminal vesicles for control of prostate cancer. The laparoscopic
operation is performed through several incisions in the abdomen measuring
1/4 – 1/2 inch in length. Specially designed surgical instruments and
cameras afford the surgeon precise control and excellent visibility for performing
the operation.
How is this different from a Radical Retropubic Prostatectomy?
The radical retropubic prostatectomy is currently the most
widely performed operation for prostate cancer in the United States. This
is performed through a single incision of 5 to 10 inches in length in the
lower abdomen. The surgery done inside the body on the prostate is essentially
the same in both operations.
What are the benefits of the Laparoscopic
Radical Prostatectomy?
In our experience with this operation, patients have much less pain, are well
enough to leave the hospital sooner, and experience less blood loss than similar
men who underwent the "open" radical prostatectomy. They also can
safely return to normal physical activity several weeks sooner with the laparoscopic
operation.
Is this operation "experimental"?
This technique is new and few hospitals in the U.S. are offering it now. It
has been performed on thousands of men in Europe with excellent results. We
have an experienced team of surgeons and operating room staff who work daily
with the most advanced laparoscopic and minimally invasive technology. The
surgeons who perform the prostatectomy have together performed radical prostatectomy
on thousands of men. We have performed the laparoscopic radical prostatectomy
on more than 700 men. Our results are at least as good, if not better, than
from open surgery.
Is the laparoscopic operation
as good at removing all the cancer?
In our experience, the results in control of cancer have been equal to that
of the standard radical prostatectomy. The cancer control results in other
hospitals where this operation has been performed on hundreds of men have
also been just as good as expected with standard surgery. Unfortunately, in
approximately 15% of operations done by either technique, the cancer will
be found to have become too advanced for any surgery to remove successfully
all the tumor. In these cases, additional treatments, usually with radiation
therapy, will be recommended.
Can a nerve sparing operation
be performed?
Yes. With the improved visualization in laparoscopic surgery, the nerve bundles
are very well seen and our technique is designed to preserve them. Return
of erections even after the most careful nerve sparing operation can take
nine to eighteen months. Several of the men on whom we have operated have
already regained erectile function with the help of Viagra.
What about blood loss?
We have found that the laparoscopic operation results in a substantially decreased
average blood loss compared to standard radical prostatectomy. This is a result
of the gas used to inflate the abdomen in this type of surgery. The pressure
of the gas compresses the veins of the pelvis, so they have much less tendency
to bleed while surgery is performed. We do not routinely recommend patients
bank their own blood prior to surgery, but many men feel more comfortable
having their own blood in reserve in case it is necessary. This can easily
be arranged through our blood bank.
How long do I stay in the hospital?
All patients arrive at the hospital the day of the surgery. Then most will
be ready to go home after two nights. Many men have safely and comfortably
gone home the day after the surgery. The length of time each man requires
in the hospital varies and is determined by the physicians and the patient
day by day.
How long does the catheter stay
in?
The healing of the bladder to the urethra has been extensively studied and
takes at least one week to progress to a point where the catheter is no longer
required. We remove the catheter between 10 days and 2 weeks after the surgery
to allow for proper healing time.
What is the recovery time?
One of the advantages of the laparoscopic surgery is the
improved recovery period. Generally vigorous physical activity should be avoided
for three weeks, but normal activities can be resumed within the first week
after surgery.