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Prostate Cancer Treatment Guide

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Prostate Cancer
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Prostatectomy

Prostate Surgery

Prostatectomy is the removal of the prostate by surgical incisions in abdomen or perineum, or small incisions and laparoscope use. Prostate Surgery

Prostatectomy is the removal of the prostate by surgical incisions in abdomen or perineum, or small incisions and laparoscope use.

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Prostatectomy Patients

Prostatectomy carries surgical risks and possible side effects so is usually recommended only for younger patients who are in otherwise good health. Prostatectomy Patients

Prostatectomy carries surgical risks and possible side effects so is usually recommended only for younger patients who are in otherwise good health.

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Prostate Removal

Length of prostatectomy surgeries, recovery times, and hospital stays vary according to specific prostatectomy procedure. Prostate Removal

Length of prostatectomy surgeries, recovery times, and hospital stays vary according to specific prostatectomy procedure.

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Prostatectomy
Survival Rates

Multiple long-term studies indicate recurrence-free success rates over 90%. Prostatectomy
Survival Rates

Multiple long-term studies indicate recurrence-free success rates over 90%.

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Risks of
Prostatectomy

Surgical complications, impotence, or incontinence may occur. Risks of
Prostatectomy

Surgical complications, impotence, or incontinence may occur.

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Prostate News

Click here for the latest news on Prostatectomy.Prostate News

Click here for the latest news on Prostatectomy.

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Prostatectomy
Videos

Click here to view Prostatectomy procedures. Prostatectomy
Videos

Click here to view Prostatectomy procedures.

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Prostatectomy
Experiences


Click here to share your Prostatectomy experiences.Prostatectomy
Experiencse

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Brachytherapy

Chemotherapy

Cryotherapy & Cryosurgery

Hormone
Therapy

Radiation
Therapy

Robotic Prostatectomy

Watchful
Waiting

Complementary
and
Alternative Medicine

High Intensity
Focused
Ultrasound (HIFU)

Emerging Technologies

 

Laparoscopic and Robotic Prostatectomy

Laparoscopic radical prostatectomy and robotic prostatectomy are two surgeries for prostate cancer treatment. The two are similar, but robotic surgery is performed with a machine that is controlled by a surgeon and laparoscopic surgery is performed by the surgeon. Patients who want to opt for one of these procedures should look for surgeons who are experienced in a specific technique. Whether a surgeon performs well either manually or robotically depends mainly on experience.

The laparoscopic and robotic prostatectomies are performed using one of two approaches: extraperitoneal and transperitoneal. The peritoneum is a thin membrane that covers the abdominal cavity. The extraperitoneal prostatectomy does not cut through this membrane, while the transperitoneal prostatectomy does. Some doctors cite shorter recovery times and fewer complications for patients who have undergone the extraperitoneal prostatectomy.

The laparoscope is a slender instrument that is shaped like a tube. A surgeon is capable of seeing through the laparoscope and performing the prostatectomy through a series of small incisions, as opposed to one long abdominal incision. The surgeon uses the laparoscope to gradually detach and remove the prostatic tissue. Researchers are still a few years from knowing whether the laparoscopic prostatectomy is capable of removing all of the prostatic tissue and having the same outcomes as the radial perineal and retropubic prostatectomies. A few of the advantages of laparoscopic prostatectomy include quicker recovery time and less abdominal pain.

During the Prostate Surgery
During the prostatectomy, the patient lies supine in some degree of the Trendelenburg position. Supine means on the back and facing up. The Trendelenburg position means the pelvis is raised above the head and the head is lowered between 15 and 45 degrees. The surgeon makes 5, or sometimes 6, small incisions in the lower abdomen. The number and pattern of the incisions depend on whether the prostatectomy is transperitoneal or extraperitoneal. Because there is no large incision that gives the surgeon an open view of the prostatectomy, removal of the lymph nodes to determine metastasis as well as the nerve-sparing technique become extremely difficult. Patients for whom maintaining sexual potency is a priority and who want the laparoscopic or robotic procedure should find surgeons who are experienced with the nerve-sparing technique in this type of prostatectomy.

In the robotic prostatectomy, a surgeon sits at a console and performs the surgery remotely. The robot that “performs” the surgery consists of the surgeon console, the display system, the master arms, the control panel, the central processing unit, and the robotic arms. The surgeon controls the master arms which control the robotic arms that hold the surgical tools. The surgeon receives feedback from the machine which indicates the pressure exerted by each tool on the patient. The surgeon uses the display system to view the stereoscopic image of the prostatectomy. The image may be in 2 dimensions or 3 dimensions with variable angles and magnifications.

Advantages of the Robot
There are some advantages, mostly for the surgeon, during robotic prostatectomy. The movements of the master control are intuitive, meaning that when the surgeon moves the control to the right, the tip of the instrument is moved to the right. The laparoscopic prostatectomy is counterintuitive, which means direction is reversed. The robotic arms do not tremor as human hands do and the display screen is capable of zooming and scaling in a way that the human eye cannot. The robotic instruments have a greater range of motion than a human wrist. Though these benefits appear to make the robotic surgery more desirable, patients should remember that an experienced surgeon performing a laparoscopic prostatectomy is usually a better choice than an inexperienced surgeon performing a robotic prostatectomy. The best medical results are correlated with experience.

 
 
 
 

 
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