Prostate cancer is one of the most common cancers in men, but advancements in surgical technology are transforming the way it is treated. For men diagnosed with localized prostate cancer, robotic nerve-sparing radical prostatectomy offers a highly effective, minimally invasive solution that prioritizes both cancer control and quality of life.

At Busamed Gateway Private Hospital, Dr. Avikar Singh offers this cutting-edge surgery using the da Vinci® robotic system. Collaborating with a team of national and international prostate cancer experts, Dr. Singh ensures every patient receives personalized and evidence-based care throughout their treatment journey.

Here, we provide a comprehensive overview of what this procedure involves, including the step-by-step process from admission to recovery, and key information to help you prepare for this life-changing surgery.

Understanding Robotic Nerve-Sparing Radical Prostatectomy

A radical prostatectomy involves surgically removing the prostate gland and seminal vesicles to eliminate prostate cancer. In the nerve-sparing version, the surgeon carefully preserves the delicate nerve bundles that are critical for erectile function and urinary control.

Using the da Vinci® robotic system, surgeons are able to operate with greater precision and control than with traditional open or laparoscopic methods. The robotic system provides a high-definition, magnified view of the prostate and surrounding structures, enabling highly accurate removal of cancerous tissue while minimizing nerve damage.

What to Expect: From Admission to Recovery

1. Admission Process

• Preoperative Consultation:

  • You’ll have an in-depth discussion with Dr. Singh about the procedure, its benefits, and potential risks. Preoperative imaging, such as an MRI or ultrasound, will be reviewed to plan the surgery.
  • Routine health checks, including blood tests and an ECG, will confirm your readiness for surgery. You may need to adjust or stop certain medications (e.g., blood thinners) in advance.

• Hospital Admission:

  • Admission usually occurs the day before or the morning of surgery. A hospital nurse will prepare you for the procedure, including setting up an intravenous (IV) line for fluids and medications.
  • You’ll be asked to fast starting the night before surgery.

2. The Surgical Procedure

• Anesthesia:

  • The procedure is performed under general anesthesia, so you will be asleep and pain-free throughout.

• Operative Time:

  • Surgery typically takes 2 to 4 hours, depending on the complexity of your case.

• Steps of the Procedure:

  1. Small incisions are made in your abdomen, through which robotic instruments and a camera are inserted.
  2. Using the robotic system, Dr. Singh removes the prostate gland and seminal vesicles with exceptional precision.
  3. The bladder is reconnected to the urethra to restore urinary function. If the cancer is close to the nerve bundles, partial nerve preservation may be necessary.
  4. The surgical area is inspected for complete removal of cancerous tissue before the incisions are closed with sutures or surgical glue.

3. Postoperative Care in the Hospital

• Immediate Recovery:

  • After surgery, you’ll be monitored in the recovery room until you’re fully awake. Pain management is provided, though most patients experience only mild discomfort.

• Catheter Placement:

  • A urinary catheter will remain in place for 7 to 10 days to allow the bladder to heal.

• Hospital Stay:

  • The usual hospital stay is 1 to 2 days, during which time the care team will assist with walking and other early recovery activities.

4. Recovery at Home

• Caring for Yourself:

  • After discharge, follow the postoperative care plan provided by Dr. Singh’s team. This includes instructions on managing your catheter, caring for incisions, and gradually increasing activity levels.
  • Heavy lifting and strenuous activities should be avoided for 2 to 4 weeks.

• Follow-Up Appointments:

  • You’ll return to the hospital within 7 to 10 days to have the catheter removed and to review your progress. Additional follow-ups will be scheduled to monitor PSA levels and long-term recovery.

• Diet and Hydration:

  • Eat a healthy, balanced diet and drink plenty of water to aid recovery and prevent constipation.

5. Long-Term Recovery and Outcomes

• Urinary Control:

  • Temporary urinary incontinence may occur but often resolves within 3 to 6 months. Pelvic floor exercises (e.g., Kegel exercises) can speed up recovery.

• Erectile Function:

  • Nerve-sparing surgery significantly improves the chances of regaining erectile function. Recovery time varies based on factors like age, pre-surgery erectile health, and the extent of nerve preservation. Medications and penile rehabilitation can assist during this period.

• Cancer Monitoring:

  • PSA tests are performed regularly to ensure no recurrence of cancer.

Benefits of Robotic Nerve-Sparing Radical Prostatectomy

1. Effective Cancer Control: Comprehensive removal of cancerous tissue with precise surgical margins.
2. Quality of Life Preservation: High rates of urinary continence and erectile function recovery compared to non-nerve-sparing techniques.
3. Minimally Invasive: Small incisions reduce pain, blood loss, and recovery time.
4. Advanced Precision: The robotic system allows for unparalleled accuracy during surgery.

Evidence Supporting Robotic Prostatectomy

Robotic-assisted radical prostatectomy has been extensively studied and validated in medical literature.

• Tewari et al. (2012):
  Meta-analysis of 400,000 cases showed superior preservation of urinary continence and erectile function with robotic-assisted surgery compared to open surgery.
  DOI: 10.1016/j.eururo.2012.03.055

• Ficarra et al. (2012):
  Faster recovery of functional outcomes and quality of life after robotic surgery compared to traditional methods.
  DOI: 10.1016/j.eururo.2012.05.059

• Novara et al. (2012):
  Less blood loss, shorter hospital stays, and comparable cancer control between robotic and open surgery.
  DOI: 10.1016/j.eururo.2012.05.037

Why Choose Dr. Singh and Busamed Gateway Private Hospital?

At Busamed Gateway Private Hospital, you’ll benefit from:

• State-of-the-Art Technology: The da Vinci® robotic system for precision and safety.
• Collaborative Expertise: A team approach with input from leading prostate cancer specialists.
• Personalized Care: Tailored plans to ensure the best outcomes for your specific situation.

Take the Next Step

If you’ve been diagnosed with prostate cancer and are considering robotic surgery, schedule a consultation with Dr. Avikar Singh