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Robotic Assisted Laparoscopic Prostatectomy/Open Radical Prostatectomy Prostatectomy is the surgical removal of all or part of the prostate gland. Prostatectomy is most often used to treat prostate cancer that is in its early stages and has not spread outside the prostate. In Robotic Assisted Surgery the surgeon guides robotic arms that hold the surgery tools. 
Robotic Prostatectomy
• During the procedure the surgeon makes several small incisions in the belly. A telescopic instrument is inserted into one of the incisions providing a three dimensional magnified view of the prostate and the nerves and tissues surrounding it. The surgeon then proceeds to guide the robotic arms and remove the prostate.
• The procedure is inpatient performed under general anesthesia and lasts between 3-5 hours.
• You can expect to be in the hospital for 1 to 2 days.
Open Prostatectomy
• During the procedure the surgeon makes an incision in the lower abdomen and locates the prostate. The prostate is then surgically removed. A catheter is inserted into the bladder and the urethra to help drain urine and will stay in for up to 2 weeks.
• The procedure is inpatient and performed under general anesthesia, surgery may take up to 4 hours.
• You can expect to be in the hospital for1-3 days.
• Also a drain will be placed into the abdomen which in most cases is removed prior to discharge.
Possible complications of these procedures include:
• Bleeding.
• Infection.
• Injury to the rectum.
• Blood clots in the legs (deep vein thrombosis).
• Injury to adjacent tissues or organs.
• Hernia.
• If difficulty is encountered during robotic surgery it may be necessary to convert to open surgery.
Specific Complications:
• Urinary Incontinence: Every patient will not have control of their urine after the catheter is removed. Greater than 90% of patients will regain control by 1 year. If possible treatment with a physical therapist started before surgery and continuing afterwards will help hasten recovery.
• Erectile Dysfunction: Depending on if the nerves were spared during surgery, erectile dysfunction can occur in 20-80% of patients. You may be directed to start regular use of a vaccum erection device or oral medications to rehabilitate the penis.
Please observe the following Pre-Operative Guidelines:
• The following medications should be Avoided One Week Prior to the Date of Surgery: All aspirin (ASA) or NSAID’s (Motrin, Advil), Coumadin, Lovenox, Celebrex, Plavix (Please contact us if you are unsure about which medications to stop, Do not stop any medication without contacting your prescribing doctor).
• The Day Before Your Surgery start the pre-operative Bowel Prep (cleansing procedure): 2 bottles of Magnesium Citrate (AM, PM), 2 fleet enemas (AM, PM). Both available at the pharmacy.
• Have nothing by mouth after midnight the night prior to your procedure unless otherwise instructed by the anesthesiologist.
After the Procedure:
• You can expect to have incisional discomfort which may require pain medicine (prescribed by your physician).
• Taking daily walks is strongly advised, prolonged lying down or sitting is not advised and may increase your chances of forming blood clots.
• No heavy lifting or exercising for up to six weeks.
• Please contact us if your pain continues to increase, you observe large amounts of blood or blood clots in your urine, or if you have a fever above 101 degrees. All these may be indicators of an injury or a serious infection.
• It is also necessary to schedule follow-up visits with us to assess your progress between one and two weeks after the procedure.
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