Prostate Problem Guide
Prostate Cancer Surgery - 3 Forms Of Prostatectomy
There are many forms of treatment available for prostate cancer but one of the most common treatments for early stage cancer which is confined to the prostate gland is prostate cancer surgery known as the prostatectomy.
The prostatectomy, which essentially involves the removal of the prostate gland and thus the cancerous cells contained within it, can be performed as open surgery or can be performed either laparoscopically or robotically.
Open surgery is the traditional form of surgery in which an incision is made in the lower abdomen to allow access to the prostate gland which is then removed using standard surgical techniques. This form of surgery is often used when the prostate is particularly large or where there is a suspicion that cancer may have spread to tissue immediately surrounding the prostate gland which may also need to be removed.
One problem with open surgery (and indeed laparoscopic surgery) is that the removal of the prostate gland can also damage nerves, muscles and other tissue in the region of the prostate gland leading to problems with sexual function. Recently however surgical techniques have been developed to minimize such damage and a growing number of surgeons are now skilled in nerve-sparing techniques.
In the case of laparoscopic surgery a number of small incisions are made in the abdomen to allow for the access of a series of long thin instruments which are used to provide lighting for and video of the area of the prostate gland, as well as access for the surgical instruments used to remove the prostate gland.
The latest surgical technique which is coming into increasing use is nerve-sparing robotic surgery using the da Vinci system. Robotic surgery is similar to laparoscopic surgery but requires a team of two highly skilled surgeons. The first surgeon operates beside the patient in the normal manner, while the second surgeon sits at a computer controlled console and manipulates the robotic operating arms.
The advantage of robotic surgery is that it allows for the use of extremely delicate instruments, the movement of which can be very precisely controlled. This degree of precision can lead to little or no damage to the nerves, muscles and other surrounding tissues, as long as the procedure is carried out by a highly skilled and experienced team of surgeons.
The main advantage of prostate cancer surgery is that it is a one-time procedure which, as long as the cancer is confined to the prostate gland, can often provide a complete cure for the condition. It's main disadvantage is that it can cause impotence and incontinence.