Robotic Surgery

Available options for care include watchful waiting (observation) or active surveillance, where you note changes in symptoms and monitoring results of exams and blood tests. This is used because prostate cancer often grows very slowly and some men might never need treatment for their prostate cancer.

There are many active therapy options available to men today, including chemotherapy, hormone therapy, cryotherapy, and radiation. It is possible that your doctor will recommend a radical prostatectomy, which is surgery to remove your prostate gland and nearby tissue, as well as lymph nodes that will be tested to see if the cancer has spread beyond the prostate gland.

Surgeons can perform a radical prostatectomy through open surgery, which requires a large incision in your abdomen, or a minimally invasive approach. In traditional open surgery, the surgeon looks directly at the surgical area through the incision and removes the prostate gland using hand-held tools.

There are two minimally invasive approaches: laparoscopic prostatectomy and robotic-assisted surgery, possibly with da Vinci technology. Surgeons perform minimally invasive laparoscopic or robotic-assisted surgeries through a few small incisions or a single small incision. To perform a laparoscopic prostatectomy, surgeons use special long-handled tools while viewing magnified images from the laparoscope (camera) on a video screen.

Potential Benefits with da Vinci

• Patients may experience similar, or sometimes faster, return of erectile function than patients who had open.
• Patients may experience similar, or sometimes faster, return of urinary continence than patients who had open within 6 months of surgery.
• When compared to patients who had open surgery, patients undergoing surgery with da Vinci may have less chance of being readmitted to the hospital after leaving.
• Patients may experience similar or fewer complications after surgery compared to patients who had open surgery.
• Patients may stay in the hospital for a shorter amount of time than patients who had open surgery.

After diagnosis, doctors are likely to do more tests to learn as much as they can about the cancer and your overall health before deciding on the next steps. There are many options available for care today, including chemotherapy, immunotherapy, systemic targeted therapies, local therapies that target the tumor directly, and radiation therapy.

Your doctor may recommend a partial or radical nephrectomy, which is surgery to remove some (partial) or all (radical) of the affected kidney or kidneys. In radical nephrectomies for kidney cancer, surgeons also remove the adrenal gland that sits above your kidney, surrounding fat, and nearby lymph nodes, which will be tested to see if the cancer has spread. In a partial nephrectomy, also called “kidney-sparing” surgery, the surgeon removes the tumor while leaving as much healthy kidney tissue as possible.

Surgeons can perform partial and radical nephrectomies through open surgery or a minimally invasive approach. Traditional open surgery requires a long incision in your side, abdomen, or back and may also require doctors to take out your lowest rib. During open surgery, the surgeon looks directly at the surgical area and removes part or all of the kidney using hand-held tools.

There are two minimally invasive approaches to radical and partial nephrectomies: laparoscopic surgery and robotic-assisted surgery, possibly with da Vinci technology. Surgeons perform minimally invasive laparoscopic or robotic-assisted surgeries through a few small incisions. To perform a laparoscopic nephrectomy, surgeons use special long-handled tools while viewing magnified images from the laparoscope (camera) on a video screen.

Why surgery with da Vinci?

A review of published studies suggest that potential benefits of a partial nephrectomy with da Vinci technology include:

• Patients may experience fewer overall complications than patients who had open or laparoscopic surgery.  
• Patients may stay in the hospital for a shorter amount of time than patients who had open surgery or shorter, or similar, time than patients who had laparoscopic surgery. 
• Patients may experience less pain than patients who had open surgery.
• Surgeons may be less likely, or with similar likelihood, to switch to an open procedure when performing surgery with da Vinci, compared to when performing laparoscopic surgery.

To allow urine to flow again, doctors may need to remove the UPJ blockage and expand the connection between the kidney and ureter. There are three main surgical options for a UPJ obstruction: endopyelotomy, open pyeloplasty, and minimally invasive pyeloplasty.

In an endopyelotomy procedure, a doctor threads an instrument up through the bladder and ureter into the kidney junction to cut or burn away blockages.

During pyeloplasty surgery, the surgeon detaches the ureter and removes any blockage, such as a too-narrow junction, scar tissue, or kidney stones. The surgeon then reattaches the ureter to the kidney so that urine can drain into the bladder.

Surgeons can perform pyeloplasty using open surgery or a minimally invasive approach. Traditional open surgery requires an incision long enough for surgeons to look directly at the kidney, junction, and ureter while performing the surgery using hand-held tools.

There are two minimally invasive pyeloplasty options: laparoscopic surgery and robotic-assisted surgery (possibly with da Vinci technology). Both are both performed through a few small incisions. To perform a laparoscopic pyeloplasty, surgeons use special long-handled tools while viewing magnified images from the laparoscope (camera) on a video screen.