Robotic surgery, radical prostatectomy
Robotic radical prostatectomy is a minimally invasive surgery to remove the cancerous prostate gland and some of the tissues surrounding it. We use a state-of-the-art robotic surgery system to remove the prostate through several small incisions rather than one large incision.
Benefits:
- Robotic prostate surgery is extremely precise and offers several advantages over traditional (open) prostate surgery.
- Smaller cuts
- Shorter hospital stay
- less pain
- Less risk of infection
- Less blood loss and transfusion
- less scarring
- faster recovery
- More successful nerve-sparing technique
In addition, in robotic prostate surgery, the temporary catheter stays in place for a much shorter time (5-7 days instead of two weeks), and the risk of urinary incontinence (urinary incontinence) and erection problems (impotence) following the robotic prostate surgery procedure is very low in experienced hands.
Robotic Surgery
(Robot Assisted Laparoscopic Radical Prostatectomy Minimally Invasive Surgery):
The camera, which transmits the 3D HD real image of the instruments and the operation area to the surgeon console, is sent to the patient’s operating area through small incisions. By controlling these instruments, which can rotate 540 degrees from the console in the operating room, the surgeon performs the operation in very narrow spaces with maneuvers that human hands cannot do.
The biggest advantage of robotic surgery to prostate cancer surgery is that instruments can be moved freely in very narrow spaces. The prostate is found only in men, and the pelvic area of men is much narrower than that of women. During the operation, the prostate is separated from the bladder and urethra, and the bladder is brought closer to the urethra and joined together. Thus, the urinary tract is restored. This method, which helps to protect the nerves, minimizes the risks of urinary incontinence and sexual insufficiency after surgery. In addition, the small incisions made during the surgery allow the patient to return to his daily life faster after the surgery.
The most important factor in the treatment of early stage prostate cancer is the experience of the doctor!
What treatments can be used in early-stage prostate cancer? Active monitoring, surgery: radical prostatectomy (open, laparoscopic or robotic), radiotherapy (radiation therapy) and brachytherapy, experimental treatments (cryotherapy, hifu) are among the alternatives. Among these treatments, surgery is the most successful in terms of cancer control. however, there is a risk of urinary incontinence of up to 5% in good centers. The deterioration of sexual functions is seen between 30-50%, despite the protection of the nerves. Surgical techniques have been performed with robotic surgery in recent years in parallel with the developing technology. Robotic surgery has been frequently preferred in recent years due to its small surgical scar, less bleeding, more effective application of the nerve-sparing technique, shorter probe time, and faster and painless recovery.
As a result; There are successful treatment alternatives in prostate cancer. Tumor-free, long and healthy life is possible. The most important point is that a patient-specific treatment is performed in an experienced center with an experienced physician.
It is possible to treat prostate cancer without doing anything, just by watching!
What does active monitoring mean? When my patient, whom I mentioned above, asked exactly what “active monitoring” was, I explained that it was “just watching” without performing treatments such as surgery or radiotherapy (radiation therapy). Of course, our patient was very surprised and asked what this meant. My answer was simple. “Some prostate cancers progress so slowly that they live with you and die with you. It won’t go fast enough to hurt you. Active follow-up is a good option since the cancer in our patient was that type of cancer. Of course, if it accelerates more than we expected in the follow-ups and becomes harmful, I may have to remove the prostate with surgery. This is of course good news! Think about it, “I wonder if I will be able to live?” You hear a suggestion from the doctor you came to by asking yourself, “We will just watch”. Here, there is probably no better news than this! Although the logic of active monitoring is not immediately understood by the patient, it comes to a very good point as it is understood over time. Of course, the important thing here is to identify the cancer suitable for active follow-up with the correct diagnosis and professional experience, and the patient who will adapt to this process, and to continue the treatment accordingly. Of course, that’s our job too.
Sleeping with the enemy… (Active monitoring) Are prostate cancer cells a Trojan horse in our body?
Of course, what I’m talking about here is not the 1991 American movie “Sleeping with the Enemy” starring Julia Roberts. I am talking about the way of defining the feelings of the patients I am actively following up for prostate cancer because of cancer. Because the prostate organ of the patient under active monitoring and the cancer cells in it continue to live with the patient. In a way, it takes no treatment. If the patient is obsessed with the cancer cells in his body and stresses and panics, he may think that he is living with the enemy. Kind of like in the famous “Trojan horse” story, he may feel that he can sneak up on him from the inside and harm his body. At this point, I plan the treatment for myself, taking into account all these concerns of my patient. Active monitoring option, patient’s examination findings, blood values, I make a decision by looking at the pathology results and films, and most importantly by understanding the sociocultural structure and expectations of the patient. In other words, the most important point for me as a physician is to make the right decision together with the patient. Because if active monitoring is applied to unsuitable people and the wrong patient, the results can be very dire! For example, in people with panic disorder such as anxiety, the option of “active monitoring”, which means living with prostate cancer, often fails and the patient cannot live with panic this time, and the fear that the cancer will harm may become more harmful than the effects of cancer. I talk to my patients like this and tell them that if necessary, it would be better to turn to other options such as surgery. is to make the right decision together with the patient. Because if active monitoring is applied to unsuitable people and the wrong patient, the results can be very dire! For example, in people with panic disorder such as anxiety, the option of “active monitoring”, which means living with prostate cancer, often fails and the patient cannot live with panic this time, and the fear that the cancer will harm may become more harmful than the effects of cancer. I talk to my patients like this and tell them that if necessary, it would be better to turn to other options such as surgery. is to make the right decision together with the patient. Because if active monitoring is applied to unsuitable people and the wrong patient, the results can be very dire! For example, in people with panic disorder such as anxiety, the option of “active monitoring”, which means living with prostate cancer, often fails and the patient cannot live with panic this time, and the fear that the cancer will harm may become more harmful than the effects of cancer. I talk to my patients like this and tell them that if necessary, it would be better to turn to other options such as surgery. For example, in people with panic disorder such as anxiety, the option of “active monitoring”, which means living with prostate cancer, often fails and the patient cannot live with panic this time, and the fear that the cancer will harm may become more harmful than the effects of cancer. I talk to my patients like this and tell them that if necessary, it would be better to turn to other options such as surgery. For example, in people with panic disorder such as anxiety, the option of “active monitoring”, which means living with prostate cancer, often fails and the patient cannot live with panic this time, and the fear that the cancer will harm may become more harmful than the effects of cancer. I talk to my patients like this and tell them that if necessary, it would be better to turn to other options such as surgery.
Prostate equals Sexual problems? What is the underlying mechanism of prostate diseases causing sexual problems?
When the prostate is mentioned, a problem related to sexuality and especially erection problems come to mind. In fact, most prostate patients do not have such a problem, but in some cases, prostate and related conditions or prostate surgeries may cause erection problems. The main reason for this is that the nerves of the prostate and penis are anatomically very intertwined. In fact, the nerves of the penis (neurovascular bundle) pass through the outermost membrane of the prostate and even give small branches into the prostate.
nerves of the penis When the prostate is so close to the prostate, it is impossible not to be affected by the diseases and treatments of the prostate. Problems with erection can occur when the nerves of the sea are affected. Especially when prostate cancer approaches the outer membrane of the prostate, this type of erection problem may occur. During surgery for prostate cancer, especially radical prostatectomy, the nerves of the penis are affected in 70% of patients and erection problems occur. Radical prostatectomy, which has been used as a very successful cancer treatment for more than 30 years, has been performed with nerve-sparing methods for nearly 20 years. For more than 10 years, laparoscopic and robotic surgical methods and nerve-sparing methods have been developed. Despite all these developments, nerve sparing methods are not at the desired point in preventing erection loss.
The proximity of the nerves of the prostate and penis can cause serious erection problems in radiotherapy treatment. Because the erection nerves are also affected in the area where the radiation is given.
People who have had prostate cancer surgery (do not) have children!
Radical prostatectomy surgery, which has been applied for more than 30 years in a patient with prostate cancer, shows a serious success in the treatment of cancer at the level of 90s out of 100. However, after the cancer is cured after the surgery, the biggest problem of the patients is sexual dysfunction. Dry orgasm, that is, loss of ejaculation, occurs in people who have undergone surgery for prostate cancer. Patients who want to have children should be warned that they will not be able to have children in the normal way after surgery. If the person has a plan to have a child after the surgery, two ways can be suggested. In the first preference, the patient’s sperm can be stored after the operation in vitro fertilization (IVF) or inoculation (IUI) in laboratories specialized in sperm freezing. In the second choice, she can have a child by taking sperm directly from the testicle after the surgery.
If operated, prostate cancer will spread throughout the body! False
This belief is not entirely true. Prostate cancer surgery is one of the most frequently performed cancer surgeries in the world. This surgery, which has been performed for more than 30 years, is one of the safest cancer surgeries. The most important factor during surgery is the experience of the surgeon. Surgical margin positivity, that is, the risk of leaving a tumor behind, was found to be lower in doctors with more than 500 surgical experience.
Leave a Reply