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The Benefits of Robotic Prostatectomy
Precise cuts and surgeon preference are pushing procedures to outpatient ORs.
Danielle Bouchat-Friedman
Publish Date: July 13, 2020   |  Tags:   Robotic Assistance
MINIMALLY INVASIVE Single-incision robotic radical prostatectomy requires only a 3 cm incision below the belly button.   |   Jihad Kaouk, MD

Robotic assistance has revolutionized prostate removal. It's a far better option than removing the gland through a large incision, which can cause significant blood loss and often leaves patients suffering from incontinence and erectile dysfunction. It's even an improvement over laparoscopic prostatectomy, a challenging procedure that demands masterful technique to remove the prostate from deep within the pelvic cavity.

With a robot, surgeons are able to remove the prostate through a few small incisions or even a single incision. Robotic prostatectomy has evolved into the preferred method for both surgeons — who prefer the precision and ease of operating robotically — and patients, who recover sooner and with fewer complications.

"About 90% of all prostatectomies in the country are done robotically," says Ryan Dobbs, MD, a robotics fellow at the University of Pennsylvania Medical Group in Philadelphia. He says the increasing numbers of robotic prostatectomies are helping to shift more cases to outpatient facilities.

"It would be unimaginable to safely discharge patients on the day of surgery without the robot," explains Dr. Dobbs. "We can after robotic procedures because patients lose less blood and, because we're making smaller incisions, they have less pain. These factors make the procedure safer and feasible in outpatient ORs."

Jihad Kaouk, MD, says the robot is also more effective for operating on patients who are obese, have had previous abdominal surgery or present with a complex or enlarged prostate.

Learning to use the robot is fairly straightforward, according to Dr. Kaouk, a professor of surgery and director of the Center for Robotic and Image Guided Surgery at the Cleveland Clinic. "The short learning curve is why the vast majority of urologists now perform the procedure robotically," he says.

It would be unimaginable to safely discharge patients on the day of surgery without the robot.
Ryan Dobbs, MD

Surgeon experience still matters, however. "The robot is a tool — there's nothing magical about performing the procedure with a robot and complications can still happen," says Dr. Kaouk. "The robot is a machine and its performance depends on the skill of the surgeon."

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