What to expect: Laparoscopic Radical Prostatectomy

If surgery is the best option for your prostate cancer, my preferred approach is laparoscopic (keyhole) surgery.  Laparoscopic techniques have advantages over open surgery of decreased blood loss, less post-operative pain, and a shorter hospital stay.

I perform laparoscopic radical prostatectomy at St Vincent’s Private Hospitals (East Melbourne and Fitzroy), Epworth Freemasons and St Vincent’s Public hospital.

What is the preparation for the surgery?

In the lead up to your surgery, it is worthwhile seeing one our practice nurses to discuss the practical aspects of your surgery, and to get some instruction on pelvic floor exercises.  These exercises will be useful in the return of your bladder control after the surgery.

What can I expect in hospital?

The operation is performed under a general anaesthetic.  It may take between 3 and 4 hours.  Afterwards, you will have 4 or 5 small wounds in the abdomen, including an abdominal drain tube.  You will also have a urinary catheter, so there will be no need to pass urine.  The abdominal drain will usually come out the next day, and most men are in hospital for 1 or 2 nights.

What happens at home?

You will go home with the urinary catheter and a leg bag that can be worn under your clothes.  We will arrange for you to come to the rooms to have your catheter removed after 1-2 weeks.  Once the catheter is out, your pelvic floor exercises will resume.  Expect to initially need to wear pads for urinary incontinence.  Continence will return as part of your body’s healing, and as your pelvic muscles adjust to having to do more work to keep your bladder closed.

There is a risk of blood clots in the legs after pelvic surgery.  We will teach you how give yourself a small injection of blood thinner each day for 30 days after the operation, in order to manage this risk.

What about robot assisted surgery?

Keyhole surgery can also be achieved with the help of a robotic device.  The Da Vinci robot is a wonderful engineering achievement.  The robotic arms mimic the movements of the surgeon, who sits in a console away from the patient.

Robotic surgery has several theoretical advantages, although actual results between robotic assisted and pure laparoscopic radical prostatectomy are very similar.

I perform robot-assisted surgery using the Xi Da Vinci robots at Epworth Freemasons and St Vincent’s Private (Fitzroy).