Laparoscopic radical prostatectomy is a minimally invasive surgery procedure used to remove a patient's cancerous prostate. Laparoscopic surgery differs from traditional open surgery by making five small incisions as opposed to one large one to perform the surgery. This leads to less abdominal trauma, better cosmetic outcomes, and typically a faster recovery process.
How long does this surgery take?
Although this surgery takes approximately 3 hours to perform, patients generally feel much better and have significantly fewer pain requirements in the early operative period. Unlike open surgery where the catheter stays in for two to three weeks, most laparoscopic prostatectomy patients have their Foley catheters removed on the third day after surgery.
What are the advantages of this procedure?
Traditional surgery for tumor removal requires an eight-inch incision, at a minimum. The minimally invasive technique requires four or five tiny incisions (of less than half an inch) for the surgical instruments. Laparoscopic prostatectomy offers surgeons unparalleled visualization of the pelvic area, thus permitting precise removal of the prostate. Patients also experience significantly less blood loss.
- Additionally, patients benefit from:
- Reduced hospital stay (1½ days average) and faster healing
- Less postoperative pain
- Shorter recovery time
- Quicker return to normal activity (one to two weeks) and work (two to three weeks)
- Smaller incisions and less scarring
How long has Cleveland Clinic been performing laparoscopic prostatectomies?
Cleveland Clinic has the most experience of any health care center in the United States related to laparoscopic prostatectomy. Our specialists have been performing laparoscopic prostatectomy procedures for the past three years.
We are investigating the long-term effects of the procedure versus the open radical prostatectomy. Preliminary results suggest that return to continence and potency is comparable to that of the open procedure.
Our staff will provide a comprehensive evaluation and refer you to the appropriate physicians for your specific condition.
Why would someone need a laparoscopic prostatectomy?
Laparoscopic radical prostatectomy is used to treat patients who have localized prostate cancer. We offer this procedure to all patients who are candidates for open radical prostatectomy.
What happens before laparoscopic prostatectomy?
Your Cleveland Clinic doctor will provide you with specific instructions for how to prepare for surgery. Because each patient is unique, your doctor will help guide you through each step of the surgical process. However, there are some common ways that patients are to prepare for surgery. This includes modifying your diet, preparing your bowels, and modifying medication/supplement routine.
You will be asked to stop eating or drinking anything besides a clear liquid diet the day prior to surgery. Doctors recommend you abstain from drinking anything after midnight the day prior to surgery. If your doctor has prescribed medication for you to take, you'll be expected to take them with a small sip of water.
You'll be asked to stop taking blood thinning medications (such as aspirin, Coumadin, or Plavix) one week prior to surgery. However, it is important for you to listen to your doctors instructions regarding changing your medication routine, every patient is different.
Cessation of tobacco smoking is also vital for the healing process. Tobacco limits the flow of oxygen through the body which is needed to heal faster.
What happens during laparoscopic prostatectomy?
You will be placed under general anesthesia. This will put you to sleep for the duration of the surgery. Then your surgeon will make small incisions to insert surgical instruments and a camera.
The surgeon then removes the prostate gland from the surrounding tissue. The seminal vesicles, two small fluid-filled sacs next to your prostate, are also removed. The surgeon will reattach the urethra to a part of the bladder called the bladder neck.
At this point, your surgeon may also (depending on the patient) remove the lymph nodes for biopsy to check for cancer.
What happens after laparoscopic prostatectomy?
After surgery, you will be hospitalized for approximately two to three days so that doctors can monitor your recovery process and ensure no complications occur after surgery.
Your diet will consist of fluids shortly after the procedure and after you’re cleared by your doctor, you may begin to eat regularly again.
You will be encouraged to walk soon after your surgery. This helps prevent complications and helps the healing process by circulating blood in your body.
After you are discharged from Cleveland Clinic, it is normal to feel tired for several weeks after the procedure. It is important however to keep doing light exercise such as walking to continue the healing process.
Any heavy lifting should be avoided for at least three weeks after surgery to avoid injury.
The most important thing is to take it easy and to return to normal activities on a timeline that feels right for you.