WHAT IS PROSTATE CANCER AND HOW TO DETECT IT

Prostate cancer is the most common tumor in men and is the second leading cause of cancer mortality in men (behind lung cancer). It occurs when tumor cells with the ability to infiltrate other organs are located in the prostate. When the tumor is in its initial phase, without infiltration in other organs or metastasis, Radical Prostatectomy allows the cells that cause the tumor to be completely eliminated.

The prostate is a glandular organ that belongs to the male reproductive system. Its main function is to produce part of the seminal fluid necessary for ejaculation. The size of the prostate varies throughout life, although it is normal for it to be about 4 centimeters long and 3 centimeters wide. From the age of 45 it is recommended that men go to the urologist at least once a year since, from that age, they are more likely to suffer both Benign Prostate Hyperplasia, (non-malignant growth of the size of the prostate), like Prostate Cancer. In these reviews, different diagnostic tests are performed (IPSS test, digital rectal examination, PSA analysis …) that determine whether or not there is an abnormal growth of the prostate and if so, whether it is a benign or malignant growth.

90% of cases are diagnosed in people over 65 years of age and the mean age of diagnosis is 75 years

Minimally invasive radical prostatectomy

Inside the pelvic cavity, the surgeon proceeds to perform the Radical Prostatectomy. Thanks to the high definition 3D endoscopic camera of the Robot, the surgeon can see the prostate gland from all angles, being able to carry out a more complete and precise work. This visibility and the maneuverability of the Da Vinci Robot’s tools allow it to carry out 360º movements and in positions impossible for the human wrist. The surgery concludes with the removal of the entire prostate minimizing damage to the muscles and nerves responsible for urinary continence and erection, something more complicated in open or traditional laparoscopic procedures.

ADVANTAGES OF OPERATING WITH
THE DA VINCI ROBOT

Greater precision for the surgeon, better results for the patient

• SAFER. The risks of conventional open surgeries and possible human errors are minimized thanks to the security systems implanted in the processor.
• LESS INVASIVE. By making small incisions through which the surgical arms of the Robot act, there are fewer postoperative complications, less pain, less scarring and less bleeding.
• BETTER RECOVERY. As it is a minimally invasive intervention, the recovery is faster and the hospital stay shorter than when an open radical prostatectomy is performed.
• MORE PRECISE. In addition to facilitating intervention in areas that are difficult to access for the surgeon, the high-magnification capacity provided by the console provides perfect three-dimensional visibility so that the surgeon can make incisions in microsurgery, something almost impossible in laparoscopic or open surgeries .
• FASTER. Hospital admission time is reduced. The patient can leave the hospital 4-5 days after the intervention compared to 10 days after admission for conventional operations.
• BETTER PROGNOSIS IN PRESERVING ERECTILE POWER AND URINARY CONTINENCE. The rate of preservation of urinary continence is greater than 90%, provided that the situation of the prostate allows it, while the recovery of the erection is also preserved in a large number of occasions, provided that the nerves responsible for it can be preserved. the erection and the previous situation of the patient is ideal.

What is the Da Vinci Robot, the most advanced robotic surgery surgical technique?

It is the most advanced surgical system that currently exists to perform the most complex procedures using a minimally invasive approach.

Its extreme versatility allows it to be used in numerous surgical specialties, from urology to general surgery through gynecology, thoracic surgery, cardiac surgery, pediatric surgery and otorhinolaryngology, although its main field of application is urology. In this area, in addition to robotic prostatectomy, nephrectomies, pyeloplasties and cystectomies are performed.

Its use provides the surgeon with greater safety in the surgical technique, which represents a great benefit for the patient, who faces a less traumatic intervention, with minimal incisions, less bleeding, a less painful and faster post-operative period, with a shorter hospital stay. and a return to normal life faster and better than expected.

In the United States, 4 out of 5 Radical Prostatectomies are performed with the Da Vinci Robot

How is robotic prostate surgery performed with Da Vinci?

The medical team that will attend you in the operating room will be made up of an anesthetist, in charge of monitoring the vital signs and anesthesia of the patient; Two surgeons, one will carry out the entire procedure from the control console and the other for support, and a nurse, in charge of assisting the surgeon with the elements that he may need to carry out the operation. The type of anesthesia used for the intervention, which will last between 2 and 3 hours, will be general anesthesia.

When general anesthesia takes effect, 4 to 6 small incisions are made in the abdomen area. Carbon dioxide is then introduced into the pelvic cavity to facilitate both the surgeon’s visibility and the maneuverability of the Da Vinci Robot’s surgical arms. After that, the surgeon introduces the surgical arms of the Robot through the incisions made previously.

Once inside the pelvic cavity, the surgeon, using the tiny tools of the Da Vinci, proceeds to perform the Radical Prostatectomy. Thanks to the possibilities of the Robot’s high definition 3D endoscopic camera, the surgeon can see the prostate gland from all angles, being able to carry out a much more complete and precise work. Taking advantage of this visibility and the maneuverability of the Da Vinci Robot tools, which allow 360º movements and in positions impossible for the human wrist, the surgeon removes the entire prostate, minimizing damage to the muscles and nerves responsible for the urinary continence and erection, somewhat more complicated in open or traditional laparoscopic procedures.

After the removal of the prostate gland, it is extracted through one of the small incisions made at the beginning of the intervention. A catheter is then inserted through the urethra and the urethra at the outlet of the bladder is reconnected with the remaining urethra in the penile area, eliminating the distance caused by the removal of the prostate. The catheter will be kept for at least a week after discharge to ensure proper healing of the urethra.

Finally, the surgical arms are removed, the incisions are sutured, a dressing is placed and the patient is taken to the resuscitation room where he will remain until the effect of anesthesia wears off, patients can routinely spend the first night in the ICU for greater control of your constants and for your safety.

Specialized medical team

The Robotic Surgery unit of Clínica Premium Marbella has a renowned team of surgeons with years of experience in the field and members of the Spanish Association of Urology (AEU)

• DR. GONZALO SANZ PÉREZ
  
• DR. JUAN AROCENA GARCÍA-TAPIA
  
• DR. EMILIO JULVE
  
• DR. JAVIER GARCÍA-PENIT
  
• DR. RAMÓN BONILLA
  
• DR. JORGE SOLER