Robot-assisted surgery

Treatment of prostate cancer
Once you have undergone a prostate examination and received a diagnosis of prostate cancer, it's time to choose a treatment strategy. There are several alternatives. If your prostate cancer is not aggressive, regular check-ups with us are an option since this type of tumor is slow-growing and rarely progresses to disease. If the tumor requires treatment, prostate surgery or radiation are alternative options.

Robot-assisted Laparoscopic Prostatectomy (RALP)
Robot-assisted prostatectomy with laparoscopic technology is currently the dominant form of treatment for prostate cancer surgery. The potential for a good quality of life after surgery depends entirely on the surgeon's experience and skill. CMedical has some of Europe's most experienced robotic surgeons with excellent medical outcomes.

How does a robot-assisted prostatectomy work?
During the operation, you are under anesthesia. Robot instruments are inserted into the abdomen through small incisions, entirely controlled by the surgeon. The prostate and seminal vesicles are completely removed because prostate cancer can be present in multiple areas of the prostate.

A new connection between the bladder and urethra is created with a thin suture. In some cases, lymph nodes in the area may also be removed for analysis. Often, a nerve-sparing technique can be used to minimize the risk of impotence after surgery.

How long does the operation take?
The surgery time for RALP is usually between 2-3 hours and includes all aspects of the operation. Normally, you can start eating and drinking on the evening of the surgery day and even get up and walk.

If no complications arise, you will be discharged the next day. The catheterization time is the same as with conventional surgery, approximately 8 days.

Sick leave for men with office work is usually 2 weeks and a little longer for men with physically demanding work.

Complications?
Long-term complications with RALP are the same as with RRP, i.e., incontinence and impotence. The risk of persistent bothersome incontinence is currently very low, similar to RRP, standing at 1.6% in our quality follow-up.

Impotence, i.e., the ability to achieve a sufficient erection for sexual intercourse, is a more common side effect. The risk varies widely among different patient groups and depends on age, preoperative erectile function, and how much of the potency nerves can be preserved. If erectile function was good before surgery and nerves on both sides can be spared, there is a significant chance of potency returning. Some studies suggest that potency may recover slightly faster for those who undergo RALP compared to RRP.

How common is prostate cancer?
Prostate cancer is the most common form of cancer in Sweden. Over 10,000 men receive the diagnosis every year. The disease primarily affects older men – about half are over 70 years old, and only a few are under 40 at the time of diagnosis.

During the operation, you are under anesthesia. Robot instruments are inserted through small incisions into the abdomen, and the enlargement of the prostate is removed through the bladder. However, the outer shell of the prostate gland is left in place.

After the operation, you will have a catheter in the bladder for 7-10 days during the healing process. Normally, you can go home after an overnight stay at the hospital.

The urine flow usually improves significantly after the operation, and there is not the same risk of impotence and incontinence as after surgery for prostate cancer.

Cysts may sometimes need to be removed, and this is primarily done through robot-assisted minimally invasive surgery, where only the cyst itself is removed.

Kidney tumors are often discovered through imaging studies conducted for other reasons, and the kidney tumor is incidentally detected. Further investigation with CT scans of the abdomen and thorax is performed in connection with this. Your urologist then assesses how your specific tumor should be treated. If deemed possible, only the tumor itself is removed, and the remaining part of the kidney is preserved. In some cases, the entire kidney needs to be removed depending on the tumor's location.

The surgery is typically performed using robot-assisted minimally invasive surgery, which allows for a faster recovery. In this type of operation, you are always under anesthesia. More specific information about what you can expect will be provided before the operation.

Living a largely normal life is possible even if one kidney is removed since the remaining kidney takes over the total kidney function after the surgery.

During the procedure, the patient is under anesthesia. Robot instruments are inserted into the abdomen through small incisions, and they are entirely controlled by the surgeon. If the stricture is in the upper part of the ureter, a procedure called pyleoplasty is performed, involving the removal of the narrow portion or repositioning the ureter to prevent compression by nearby blood vessels.

If the stricture is located lower in the ureter, the narrow part is removed, and the ureter is reconnected. In some cases, a piece of mucous membrane or intestine may be needed as additional repair tissue.

A thin, soft tube is placed during the operation between the kidney and the bladder to ensure the passage of urine during the healing process. This tube is removed a few weeks later at the clinic using local anesthesia.