Advanced Robotic Surgery - Urologic

When medication and other non-surgical treatments are either unavailable or cannot relieve symptoms, surgery is the accepted treatment for a broad range of conditions that affect the male reproductive organs and the organs of the urinary tract. These conditions include, but are not limited to, prostate cancer, ureteropelvic junction (UPJ) obstruction, bladder and kidney cancer and vesicoureteral reflux.

Facing any kind of urologic surgery creates a great deal of anxiety for most men. Among your concerns is: “Will my body function normally following surgery?” Traditional open urologic surgery – in which large incisions are made to access the pelvic organs – has been the standard approach when surgery is warranted. Yet common drawbacks of this procedure include significant post-surgical pain, a lengthy recovery and an unpredictable, potentially long-term impact on continence and sexual function.

Fortunately, less invasive surgical options are available to many patients facing urologic surgery. The most common of these is laparoscopy, which uses small incisions. While laparoscopy can be very effective for many routine procedures, limitations of this technology prevent its use for more complex urologic surgeries.

A new category of surgery, introduced with the development of the da Vinci® Surgical System, is being used by an increasing number of surgeons worldwide for prostatectomy and other urologic procedures. This minimally invasive approach, utilizing the latest in surgical and robotics technologies, is ideal for delicate urologic surgery. This includes prostatectomy, in which the target site is not only tightly confined but also surrounded by nerves affecting urinary control and sexual function. Using da Vinci, your surgeon has a better tool to spare surrounding nerves, which may enhance both your recovery experience and clinical outcomes.

Prostate Cancer

The prostate is a male reproductive gland that produces a fluid found in semen. Located below the bladder and in front of the rectum, the prostate surrounds the urethra — the tube that empties urine from the bladder.

Prostate cancer affects the prostate gland and may spread to surrounding structures. While most men with prostate cancer have no symptoms, physician can find prostate cancer during a regular checkup, using a combination of a blood test called a PSA and a digital rectal exam (DRE).

Nearly one in six American men will be diagnosed with prostate cancer during his lifetime.1 With greater awareness, prostate cancer detection is on the rise and mortality is declining. Moreover, better treatments are allowing more men to return to active and productive lives after treatment.

Treatment Options

If the you have an early diagnosis of prostate cancer, there is usually a range of treatment options. These may include conservative management, radiation therapy with either external bream or brachytherapy therapy, cryosurgery and prostatectomy – surgical removal of the prostate. Your treatment options will depend on a number of factors, including the stage of the disease, your age and health or personal preference.


  1. The National Prostate Cancer Coalition: www.fightprostatecancer.org home/treatment & research/treatment options/surgery

While clinical studies support the effectiveness of the da Vinci® System when used in minimally invasive surgery, individual results may vary. Surgery with the da Vinci Surgical System may not be appropriate for every individual. Always ask your doctor about all treatment options, as well as their risks and benefits.

Prostatectomy

The gold standard treatment option for men under 70 with early-stage, organ-confined cancer is surgical removal of the prostate using nerve-sparing radical prostatectomy. Prostatectomy is also the most widely used treatment for prostate cancer today in the US.1

The primary goal of prostatectomy is removal of the cancer. A secondary goal is to preserve urinary function and -- when applicable -- erectile function. Preservation of the nerves necessary for erections can be an extremely important goal for patients. These nerves run alongside the prostate and are often damaged when removing the prostate. A nerve-sparing prostatectomy attempts to preserve these nerves so that the patient may be able to return to his prior erectile function.

Types of Prostatectomy

Approaches to this procedure include traditional open surgery, conventional laparoscopic surgery or da Vinci ® Prostatectomy, which is a robot-assisted laparoscopic surgery.

With a traditional open procedure, your surgeon uses an 8-10 inch incision to access the prostate. This approach often results in substantial blood loss, a lengthy, uncomfortable recovery and a risk of impotence and incontinence.

Conventional laparoscopy uses a specialized surgical camera and rigid instruments to access and remove the prostate using a series of small incisions. This approach provides your surgeon with better visualization than an open approach. In addition, it provides patients the benefits of a minimally invasive procedure.

Despite these advantages, conventional laparoscopy relies on rigid instruments and standard 2D video, technical limitations that can be challenging for the surgeon. Because of these drawbacks, conventional laparoscopy doesn't lend itself well to complex procedures like prostatectomy. Therefore, very few urologists use this approach for prostatectomy. Moreover, neither laparoscopy nor open surgery can provide adequate visualization for a very precise, nerve-sparing prostatectomy.


  1. The National Prostate Cancer Coalition: www.fightprostatecancer.org home > treatment & research > treatment options > surgery
While clinical studies support the effectiveness of the da Vinci® System when used in minimally invasive surgery, individual results may vary. Surgery with the da Vinci Surgical System may not be appropriate for every individual. Always ask your doctor about all treatment options, as well as their risks and benefits.

Robotic Surgery - Prostatectomy

Referred to by many as robotic surgery for prostate cancer or robotic prostatectomy, da Vinci® Prostatectomy is more accurately a robot-assisted, minimally invasive surgery that is quickly becoming the preferred treatment for removal of the prostate following early diagnosis of prostate cancer. In fact, studies suggest that da Vinci Prostatectomy may be the most effective, least invasive prostate surgery performed today.1

Though any diagnosis of cancer can be traumatic, the good news is that if your doctor recommends prostate surgery, the cancer was probably caught early. And, with da Vinci Prostatectomy, the likelihood of a complete recovery from prostate cancer without long-term side effects is, for most patients, better than it has ever been.

da Vinci Prostatectomy is performed with the assistance of the da Vinci Surgical System – the latest evolution in robotics technology. The da Vinci Surgical System enables surgeons to operate with unmatched precision and control using only a few small incisions. Recent studies suggest that da Vinci Prostatectomy may offer improved cancer control and a faster return to potency and continence.1 da Vinci Prostatectomy also offers these potential benefits: 

  • Significantly less pain
  • Less blood loss
  • Fewer complications
  • Less scarring
  • A shorter hospital stay
  • And a faster return to normal daily activities

If you are a candidate for prostate surgery, talk to a surgeon who performs da Vinci Prostatectomy.

A video on daVinci Prostatectomy is available through the Penn State Hershey Medical Center YouTube page.


  1. Most effective minimally invasive surgery in terms of cancer control, potency and continence, cancer control being defined in part by margin rates and PSA test scores. The following studies provide support for da Vinci Prostatectomy's effectiveness in these three areas: Ahlering TE, Woo D, Eichel L, Lee DI, Edwards R, Skarecky DW. Robot-assisted versus open radical prostatectomy: a comparison of one surgeon's outcomes. Urology. 2004 May;63(5):819-22. Menon M, Tewari A, Peabody JO, Shrivastava A, Kaul S, Bhandari A, Hemal AK. Vattikuti Institute prostatectomy, a technique of robotic radical prostatectomy for management of localized carcinoma of the prostate: experience of over 1100 cases. Urol Clin North Am. 2004 Nov;31(4):701-17. Tewari A, Srivasatava A, Menon M; Members of the VIP Team. A prospective comparison of radical retropubic and robot-assisted prostatectomy: experience in one institution. BJU Int. 2003 Aug;92(3):205-10. Please also see the Clinical References section of the site for additional clinical support.
While clinical studies support the effectiveness of the da Vinci® System when used in minimally invasive surgery, individual results may vary. Surgery with the da Vinci Surgical System may not be appropriate for every individual. Always ask your doctor about all treatment options, as well as their risks and benefits.

For more information or to schedule an appointment, please call our toll free CareLine at 800-243-1455 or 717-531-6955.