Prostatectomy – The prostate surgery that can cure cancer

What Is a Prostatectomy?

A prostatectomy is surgery to remove all or part of the prostate gland. The term can describe two very different operations:

• Radical prostatectomy removes the entire prostate, the seminal vesicles, and sometimes nearby lymph nodes to treat prostate cancer.
• Simple prostatectomy removes only the inner, enlarged portion of the prostate to relieve urinary obstruction from BPH.

Understanding the Prostate and Prostate Cancer

The prostate is a walnut-sized gland that sits below the bladder and surrounds the urethra. It is closely surrounded by the nerves that control erections and the sphincter muscle that controls urination. That is why the surgeon’s precision determines not just whether the cancer is removed, but how well a man recovers continence and sexual function.

Types of Prostate Surgery

1. Robotic Radical Prostatectomy

Performed with the da Vinci system through small incisions, robotic prostatectomy is now the most common surgical approach for prostate cancer.

2. Laparoscopic Radical Prostatectomy

Also minimally invasive, conventional laparoscopy uses long, straight instruments and a 2D camera. It has largely been replaced by robotic surgery.

3. Open Radical Prostatectomy

Performed through an incision in the lower abdomen (retropubic) or, less commonly, the perineum. Open surgery generally involves more blood loss and a longer recovery.

4. TURP

A transurethral resection of the prostate removes obstructing tissue through the urethra to treat BPH. It is not a cancer operation.

Why Might a Prostatectomy Be Recommended?

Radical prostatectomy is commonly recommended for men with localized, intermediate- or high-risk prostate cancer who are healthy enough for surgery and have a life expectancy of at least 10 years. Surgery offers complete pathology staging, makes PSA monitoring straightforward, and keeps radiation available as a backup if needed.

The Steps of Robotic Prostatectomy

• General anesthesia is given and several small incisions are made in the abdomen.
• The bladder is released and the prostate is exposed.
• The bladder neck is separated from the prostate, and the seminal vesicles are freed.
• The nerve bundles are gently spared when the cancer allows.
• The prostate is divided from the urethra while preserving the sphincter.
• The prostate is removed, and lymph nodes are taken if needed.
• The bladder is reconnected to the urethra over a temporary catheter.

Benefits of Robotic Prostatectomy

• Magnified, high-definition 3D view of the surgical field
• Small incisions with less pain and scarring
• Minimal blood loss and rare need for transfusion
• Usually a one-night hospital stay
• Faster return to work and normal activities
• Precise nerve and sphincter preservation

SMART Surgery: Advanced Robotic Prostatectomy

Dr. Samadi’s SMART Surgery refines robotic prostatectomy with heat-free nerve sparing and careful preservation of the sphincter and supporting tissues. Learn more about SMART Surgery for prostate cancer and robotic surgery, or call Prostate Cancer 911 at (212) 365-5000 to schedule a consultation.

Related Care and Resources at Prostate Cancer 911

• Prostate cancer treatment
• MRI fusion biopsy
• Elevated PSA evaluation
• Bladder cancer treatment
• Urinary issues
• Erectile dysfunction treatment
• Urologic oncology

Prostatectomy FAQs