Frequently Asked Questions

GENERAL

Q: Does the daVinci robotic approach result in a higher cancer cure rate than conventional surgery?

A: Because of the precision of the technique and the magnification of the daVinci laparoscopic camera, the completeness of cancer removal is reported in the literature to be as good as open surgery and in some reported series higher than open surgery.

Q: How long does the operation take?

A: Barring unusual circumstances, the total procedure normally takes less than 3 hours, but can be slightly longer depending on the difficulty of the case.

PRE-OPERATIVE

Q: Will I need to donate my own blood to have on hand during surgery if the need for a transfusion arises?

A: One of the many benefits of the daVinci robotic approach is minimal bloodloss.  Therefore, it is not necessary to donate your blood.

Q: Will this operation render me sterile?

A: Yes, all patients undergoing radical prostatectomy will not be able to father children after the procedure. However, the nerves that give the ability to have erections can be spared allowing many patients to continue to have erections and climax after the surgery.

POST-OPERATIVE

Q: How long can I expect to stay in the hospital after the procedure?

A: Almost all daVinci robotic prostatectomy patients are able to go home the day after surgery.

Q: After the daVinci robotic prostate surgery, when will I be able to resume normal activities?

A: One of the advantages of the daVinci robotic approach is decreased pain which results in easier recuperation. Thus, most individuals undergoing this operation will be able to resume light activities within 23 hours of surgery and can resume full unrestricted activity in 3 weeks. However, each individual heals at his own rate. You should listen to your body, and do what it tells you do to.

Q: After the daVinci robotic prostate surgery, will I be able to have normal sexual relations immediately after surgery?

A: No. Even when the nerves are preserved, it takes time for them to heal and function. Many patients are able to return to sexual activity but this recovery varies based on the patient’s age, whether one or both nerves were spared, and what their pre-surgical level of erectile function is.

Q: How long can I expect to be off of work after the procedure?

A: Many patients are able to return to light work in less than one week. However, many patients take time off for one or two weeks after the daVinci robotic prostate surgery. Long-term disability is not necessary after this procedure since complications are rare and recovery is typically rapid. Any further time off will be recommended if medically necessary.

GENERAL

Q: How safe is the daVinci Robot for Laparoscopic Prostatectomy?

A: The daVinci is FDA approved for radical prostatectomies and is being used routinely in over 300 locations worldwide. Each daVinci system is rigorously maintained, tested, and upgraded as necessary by Intuitive Surgical.

Q: What happens if there is a malfunction in the daVinci System?

A: In the unlikely event of malfunction, or it is not safe to continue with the robot, the daVinci system will be withdrawn and the surgery can proceed laparoscopically without it. The instruments and supplies necessary to perform the surgery without the daVinci are kept on hand so that conversion, if necessary, can occur seamlessly.

Q: My doctor tells me that the surgeon loses tactile sensation with robotic surgery. How does this affect the outcomes of surgery?

A: Tactile sensation, the ability to perceive through touch, is an important part of open radical prostatectomy surgery. The surgeon usually uses this sense in the portions of the operation where they are not able to see clearly. Although with daVinci robotic surgery true tactile sensation is lost, the ability to move the robotic camera to difficult locations within millimeters of where the doctor is working allows him to see things an open surgeon cannot, and do so with the 14 fold magnification of the robotic camera. With experience, a pseudo-tactile sensation is developed and an appreciation of tissue texture and density is achieved. The combination of enhanced vision and experience with tissue handling more than compensates for the lack of real tactile sensation. This is why the results for daVinci laparoscopic robotic surgery are so good.

Q: Many urologists feel the benefits of daVinci robotic surgery are unproven. What is your opinion?

A: Open radical prostatectomy is a highly sophisticated and finely developed operation. When it comes to surgery, whether you perform it through an open incision or via the daVinci robotic technique, the same things matter: operative time, blood loss, negative margin rates, post-surgical pain, time to recovery of urinary control, time to recovery of erections, time until recovery to full physical activity. All of this information has been published and is available on daVinci robotic surgery and it shows equal, and in some cases, better outcomes when compared to open surgery. The beauty of daVinci robotic surgery is these outcomes are accomplished while minimizing bleeding and pain. Why suffer if you don't have to?

Q: My Urologist tells me that it takes 15 years to know if a prostate cancer treatment really works. How can you tell that the daVinci surgery works if it’s only been around for 5 years?

A: Waiting 15 years to analyze prostate cancer cure rates holds true for treatments that do not remove the prostate, like radiation, because you need to wait to see if all the cancer was killed or if it will eventually return in the prostate. With surgical removal of the prostate (daVinci or the old open technique) the prostate is removed and once it’s out you can find out the surgical margins.

Surgical margins are the edges of the prostate gland and the Pathologist will look at this when the prostate is removed. If your surgical margins show no cancer at the edges, you got it all out locally. This does not mean it has not spread to other parts of the body. It just means there is nothing left behind in the spot where the prostate used to be. Data from thousands of laparoscopic and daVinci robotic prostate surgeries shows that the surgical margins are equal to, and in some series, better than, what we were seeing with the old open surgery. If the surgical margins are the same as open surgery then the only way the cancer can come back is if it spread before the surgery was done. This pre-surgery spread of disease will be the same no matter how the surgery is performed.