Prostate Cancer - robotic prostatectomy in Nottingham

• Prostate: A small gland found in your pelvis, between your penis and bladder. It is involved in the production of semen and helps with ejaculation
• Seminal vesicles: Also known as the vesicular or seminal glands, they are involved in the production and storage of semen

A radical prostatectomy is performed to treat cancer of the prostate. The aim is to cure a patient of cancer by removing the affected prostate and seminal vesicles. Typically this procedure will be offered to patients whose cancer has not spread beyond the prostate.

A radical prostatectomy is major surgery and as such it can have significant side effects, including urinary incontinence and impotence. Because of this, only highly trained Urological Surgeons perform this procedure.

At The Park Hospital in Nottingham, our Consultant Urological Surgeons run the Nottingham Prostate Centre. They offer expert, tailored treatment for prostate cancer and other prostate issues to people from Nottinghamshire and across the East Midlands, as well as further afield.

Patients travel to us from across the UK to benefit from the expertise of our Consultant Urologists as well as our cutting edge technology, including the da Vinci X surgical system, which we use to perform all our prostatectomies.

When we refer to robotic surgery, or robotics-assisted surgery, we don’t mean an operation performed by a robot. Actually, the whole procedure is still performed by your Consultant Urological Surgeon. The robotic element is simply a very hi-tech surgical platform that your Surgeon uses to help them be as precise as possible. In an operation such as a prostatectomy, precision is of the utmost importance. The more precise your Surgeon can be, the better your chances of a full recovery and the lower the risk of significant side effects.

If you are nervous about the concept of robotic surgery, be reassured that it is very commonplace. In 2020, 89% of prostatectomies in England were carried out using this technology.¹

For some patients with prostate cancer, surgeons can use a method called ‘nerve-sparing prostatectomy’. This approach aims to preserve as much of the tissue and organs around your prostate as possible, in the hope that you will retain your ability to get erections. In order to successfully use the nerve-sparing method, surgeons need to be incredibly precise in their work.

The da Vinci X surgical system

For robotic prostatectomy at the Park Hospital Nottingham, our specialists use a robot called the da Vinci X surgical system. This is a market-leading, cutting-edge machine designed to make prostate surgery as successful as possible.

The robot consists of a series of mechanical arms, which are linked to a console controlled by a highly trained Surgeon. The system translates the Surgeon’s hand movements in real time, so that the robotic arms move in the same way. The Surgeon is able to watch everything that’s happening via a high-definition, 3D real-time image.

The Surgeon can use the da Vinci robotic system to make smaller and more accurate movements than possible with their own hands. This allows them to be more precise than ever with which tissues they remove and which are preserved.

As explained above, the more precise your Surgeon is able to be, the more chance there is that you will retain the same function in your penis that you had before surgery.

Of course, no method can guarantee results. However, evidence suggests that robot-assisted radical prostatectomy offers better overall outcomes in terms of urinary continence and erectile dysfunction than open or laparoscopic prostatectomy.²

What this means for you, is that when you choose to have prostate cancer treatment at The Park Hospital, you can experience a continuity of care that you won’t get elsewhere.

No other private hospital in Nottingham (or anywhere in the UK outside of London) has the technology onsite. This means that private patients have to move between their base hospital and a private ward at an NHS hospital.

With us, every element of your treatment will take place at The Park Hospital, and you’ll see the same dedicated team from start to finish. From your very first consultation, your treatment will be led by the same Consultant, working alongside a dedicated prostate cancer specialist nursing team specialising in the care of men with prostate cancer. Our surgeons also use a hand-picked anaesthetic and theatre team. We believe this is the optimum patient pathway for our private patients.

He travelled to The Park Hospital from his home in the Vale of Belvoir to take advantage of the new technology, finding the use of cutting-edge technology reassuring. “I was relieved not to be undergoing traditional open surgery. All the information was provided in advance upfront, and I had every confidence in the expertise of my surgeon, Mr Sherwood.”

“Following the results of a biopsy on New Year’s Eve I expected to be waiting months for my surgery,” he says. For Philip, the speed of access to treatment was very important when it came to choosing The Park Hospital, as were our stringent isolation protocols.  “I was more than relieved to come to a ‘bio-secure’ Covid-free hospital”.

Mr Marsden describes his recovery as “excellent” and his experience at The Park as “tremendous, the level of care from arriving to leaving was exceptional”.

Radical prostatectomy is one of several treatments options for prostate cancer that is confined to the prostate (localised).  Your specialist will be able to guide you as to whether this is the right option for you.

Prostate removal surgery might be recommended if:

• Your cancer has not yet spread beyond your prostate
• You are young and have a tumour that is considered to be active
• You have high risk localised prostate cancer

At Circle Health Group, we have a network of experienced specialists who can help to diagnose, assess and create bespoke treatment plans for prostate cancer. Whether you have symptoms you would like investigated or have already received diagnosis of prostate cancer, our Consultant Urologists are here to help you.

In order to see one of our Consultant Urological Surgeons at Circle Health Group, you will first need a referral from a GP or consultant. If you would like advice on getting this referral, feel free to get in touch by phone (call us on 0115 9662000) or make an online enquiry.

What to expect from your initial consultation

The first step in your prostate cancer treatment journey will be a meeting with your Consultant Urologist. They will be able to tell you how far your cancer has developed and whether it has spread to any other parts of your body. If you haven’t yet had a full diagnosis, this will happen at your first consultation. If needed, you’ll be taken for scans or blood tests, which are all done on-site.

This initial consultation is an opportunity for you to ask any questions you want, however trivial they may seem. We are here to help and we want to make you feel as comfortable and informed as possible. Having treatment for cancer is a scary time, and we value compassion just as highly as medical know-how.

Deciding on the best course of treatment for you

If your cancer is contained to your prostate gland, your Consultant may recommend prostate removal surgery as the best option for you.

Because we are a private hospital group, we don’t have waiting lists for prostate removal surgery. You should be able to have your consultation within 48 hours of getting in touch, and your treatment will move as quickly as necessary from then on.

Open vs robotic prostatectomy

Compared to traditional open prostate surgery, which involves a large incision into the abdomen, the robotic technique uses just a few very tiny incisions.

For you, the benefits can include:

• Reduced blood loss
• Less pain
• A shorter stay in hospital
• Faster recovery times

You might be encouraged to do things including:

• Eat lots of nutritious foods
• Stay as active as possible
• Stop smoking (if applicable)
• Stay within a healthy weight range

Before you come in for surgery, you will also have a preoperative assessment, which may be done at our hospital but is normally completed over the phone, scheduled for a time that’s convenient for you.

A specially trained Nurse will talk you through everything you need to know and do before surgery, and they’ll take you through a questionnaire to make sure you are ready and healthy enough for the procedure. If you need any checks before your stay with us, for example blood or urine tests, we will arrange these either before or during the preoperative assessment.

We aim to give you all the information you need, from what time to arrive to whether you need to pack pyjamas. But of course, if you have any further questions, you can ask us anything you like.

When you arrive at hospital

If you and your Consultant decide that a private robotic prostatectomy is the best choice for you, our team will book you in for the procedure at a time that suits you. Many of our hospitals offer appointments outside of working hours and even at weekends.

Our team will tell you when to arrive and what to bring, and once you’re here we will get you set up with everything you need before the procedure. Your Consultant will come to speak to you, talking you through what is planned for your surgery, and answering any last-minute questions you might have. You might also meet other members of our Theatre team, such as your Anaesthetist, which can make you feel more at ease during surgery.

During the operation

Radical prostatectomies are performed under general anaesthetic, which means you’ll be asleep for the whole operation.

Your Surgeon, assisted by the da Vinci robot, will begin by making small incisions in your abdomen to gain access to your prostate. Through these, they insert a tiny camera and specially designed surgical tools.

These are used to remove the prostate gland, along with its surrounding tissues and the seminal vesicles, which are taken out through one of the small incisions. If necessary, the lymph nodes around your prostate gland will also be removed.

In removing the prostate and vesicles, your Surgeon will aim to be as precise as possible, targeting only the diseased tissues and, where possible, avoiding other delicate structures around them (nerves, blood vessels and muscles). You will often hear this referred to as a ‘nerve-sparing’ technique.

During robotic surgery, an ultra-clear high-definition video of the inside of your abdomen is shown to your surgeon in 3D in real time. This gives them a magnified view which, along with the minute surgical tools attached to the robotic arms, allows them to work with more accuracy than ever before.

A robotic prostatectomy will typically take two to three hours.

Once surgery is complete, you’ll be taken to your comfortable, private room where you’ll be provided with everything you need to recover.

What is the success rate of robotic prostatectomy?

Success of cancer treatment is often judged by how many patients are still cancer-free after five or 10 years. Radical prostatectomy* is considered a very successful operation, with survival rates of 90% or more at 10 years.³

However, it’s important to note that cancer affects everyone differently, and success rates will be heavily influenced by personal circumstances such as age and lifestyle, as well as the advancement of the disease. It’s best to ask your Consultant directly about your individual chances of recovery.

*Robotics-assisted prostate surgery is still a relatively new technique, meaning we don’t yet have enough long-term data to give five- or 10-year success rates for this specific surgery.

However, a 2007 systematic review found that the robotic technique offered results that were at least as successful as those of existing techniques (open and laparoscopic surgery).⁴ This is why we have shared data for prostatectomy overall.

You may feel a little groggy, which is a common effect of anaesthetic and painkillers. You will also have a catheter in, which may need to stay in for a few days.

As soon as you’re ready, we’ll help you to get up and moving, perhaps with a gentle walk around your room. This can help reduce postoperative risks as well as kickstarting your recovery.

When will I be discharged?

After a robotic prostatectomy, you’ll need to stay in hospital for at least one night. However, patients who return home sooner have the best rates of recovery, so we will aim to keep your stay as short as possible.

Before you go home, we’ll provide you with everything you’ll need once there, which might include painkillers or other medication. Although, many people find that over-the-counter painkillers are enough for them by this point.

You may also be shown how to remove your catheter, as some people like to do this themselves when ready (around seven to 10 days after surgery).

We will be in touch around a week or two after your procedure to give you a final report on the success of the procedure. They will let you know whether further treatment is needed.

We recommend avoiding strenuous activity and heavy lifting for at least one month after a prostatectomy. You shouldn’t drive until you can make all the movements necessary without pain.

Most people take a month or so off work. If you work from home, maybe you will feel able to return sooner. If you have a physical job, you may well need to stay off work for longer.

Temporary side effects

Some men will experience temporary urinary incontinence or erectile dysfunction after prostate surgery. These symptoms can last anywhere from a few days to a few months, and will vary from person to person. You can always speak to your Consultant if they are interfering with your quality of life. They may be able to offer treatment to help the issue.

There is also a small risk that these effects will be permanent, though your Consultant Urological Surgeon will have done their best to avoid this happening.

• Pain
• Bleeding (during or after surgery)
• Infection
• Blood clots
• Reaction to the anaesthesia

The most significant potential side-effects of having your prostate removed are:

• Short- or long-term urinary incontinence or damage to the urethra
• Short- or long-term erectile dysfunction (loss of sexual function)
• Incisional hernia
• Urethral stricture
• Injury to a surrounding structure, such as the rectum

Your Surgeon will discuss any side effects with you before deciding on the procedure, and they’ll let you know which risks are particularly relevant in your case.

At Circle Health Group we see patients with Private Medical Insurance and also patients who choose to pay for a one-off course of treatment (rather than committing to health insurance).

We will give you a fixed price before you book the procedure, which will include aftercare as standard.

This price does not include your initial consultation fee or the cost of any initial diagnostics.

We offer a selection of flexible payment options, allowing you to spread the cost of treatment over 10 months to five years. In many instances, your repayments will be interest-free for the first 10 months.

When you go private for prostate cancer treatment, you get access to leading specialists, cutting-edge technology and the latest treatments, all without the waiting list.

At Circle Health Group, we have more than 50 hospitals across England, Scotland and Wales, meaning fast access to great care is never far away.

When you choose treatment at any one of our private hospitals, you can expect:

• Consultant-led care from a multidisciplinary team of experts
• A bespoke treatment plan tailored to your individual circumstances
• A private, en-suite room with TV and WiFi included
• On site diagnostics, pharmacy and physiotherapy so you can have all your treatment in one place
• Delicious, healthy meals with all dietary requirements catered for
• Free car parking for every patient

We are currently the only private hospital group to own a da Vinci X surgical robot outside of London. The revolutionary machine is housed at the Nottingham Prostate Centre at The Park Hospital in the East Midlands.

Our Consultant Urological Surgeons specialise in minimally invasive procedures and have undergone rigorous training in order to be able to use this exciting robotic technology.

They offer world-class treatment to patients from Nottingham, Lincolnshire, Derbyshire, Leicestershire and further afield. When you go private, you can choose where you have treatment. At The Park Hospital we welcome everyone, including international patients.

If you think a robotic prostatectomy is the right option for you, don’t hesitate to get in touch today. Call us or make an online enquiry.

¹Using robotic surgery to improve patient outcomes

²Robot-Assisted Radical Prostatectomy Is More Beneficial for Prostate Cancer Patients: A System Review and Meta-Analysis

³Success and Failure of Single-Modality Treatment for Early Prostate Cancer

⁴A selected review and personal experience with robotic prostatectomy: implications for adoption of this new technology in the United Kingdom