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Robotic prostatectomy

Minimally invasive prostate surgery performed by expert consultant surgeons

A radical prostatectomy is an operation to remove your entire prostate as well as its associated structures (seminal vesicles). 

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, these are involved in the production and storage of semen.

A radical prostatectomy is performed by Urological Surgeons to treat cancer of the prostate. The aim is to eliminate cancer by removing the affected prostate and seminal vesicles.

A robotic prostatectomy, which might also be called a robotic radical prostatectomy, or a robotic-assisted laparoscopic radical prostatectomy, is a type of keyhole surgery performed with the help of a robotic system.

When we refer to robotic surgery, or robotics-assisted surgery, we don’t mean an operation performed by a robot. The procedure is still performed by your Consultant Urological Surgeon. The robotic element is simply a technical 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 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 high-definition, 3D real-time image. They 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

Prostate removal is just one of many treatments available for cancer of the prostate. There is more than one type of surgery for prostate cancer, and there are also various non-surgical treatments, such as chemotherapy or radiotherapy. 

Radical prostatectomy is one of several treatments options for prostate cancer that is confined to the prostate (localised). Your specialist will be able to inform 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, 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, 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 or make an online enquiry.

What to expect from your initial consultation


The first step in your prostate cancer treatment journey will involve 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 tiny incisions. 

For you, the benefits can include: 

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

Your Consultant will encourage you to live as healthily as possible in the weeks or months ahead of your surgery. The healthier you are before your prostatectomy, the faster you are likely to recover. You might be encouraged to adhere to certain lifestyle factors in preparation for surgery, including: 

Eating plenty of nutritious food
Staying as active as possible
Stopping smoking (if applicable)
Staying within a healthy weight range

Before surgery, you will have a preoperative assessment to assess your general health. This will be performed at one of our hospitals or via telephone consultation.

During this consultation, your Nurse will discuss everything you need to know before surgery, and take you through a questionnaire to ensure you are fit and healthy before the procedure. 

If you need any checks or examinations before your stay with us (for example, blood or urine tests) we will arrange these for either before or during your preoperative assessment. 

We aim to provide you with as much information as possible during your assessment, from what time you need to arrive at hospital for surgery, to whether you need to stay overnight with us to recover after.

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. After you arrive at hospital, we will get you set up with everything you need before the procedure. Your Consultant will talk you through what is planned for your surgery, and answer any last-minute questions you might have. You might also meet other members of our theatre team, such as your Anaesthetist.

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. After 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.2 

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).3 This is why we have shared data for prostatectomy overall.   

After your operation, you will be taken to your private hospital room and set up comfortably in your room. You’ll be visited by your Consultant, who will let you know how surgery went. 

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 gently and safely. This can help reduce postoperative risks. 

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 at this stage.

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. 

Robotic radical prostatectomy recovery is often faster than with open surgery, but it will still take time. This is major surgery and you need to give your body time to heal. 

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. 

It is important to remember complications can occur from any surgery. These can include:

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 consultant will discuss any side effects with you before deciding on the procedure.

The price of a prostatectomy starts from around £20,000.*

The final price will be different for every patient and depends on various factors. For example, you will usually pay more for robotic surgery than a traditional operation.

At Circle Health, 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.

*This is a guide price for patients who are paying for their own treatment. The actual cost of your treatment will be confirmed in writing at the time of booking.

When you go private for prostate cancer treatment, you get access to leading specialists, cutting-edge technology and the latest treatments.

At Circle Health, 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

Paul Jenkins smiles at camera with wife
Paul Jenkins underwent robotic prostatectomy for prostate cancer at The Park Hospital in Nottingham. His surgeon, Mr Ben Sherwood, used the da Vinci X surgical system to perform the procedure. Paul's experience with us was excellent. He was impressed by the quality of care he received from Mr Sherwood and his team of nurses, as well as his room and the facilities, particularly the food menu.

“The room was comfortable and spacious. The food menu was brilliant! I had no idea there would be so many options, it was like being in a hotel with a three-course food menu at my fingertips. I’m upset I didn’t have the stomach to order everything after surgery...”

Paul felt that Ben showed great compassion and kindness, even while performing complex surgery. He made a point to call Paul’s mother-in-law and his wife to assure them that, although the procedure was taking longer than usual, it was nothing to worry about, and that Paul was okay. “He was just amazing, keeping them in the loop like that. They really appreciated it,” says Paul.

It wasn’t just Mr Sherwood who helped make Paul’s experience at The Park Hospital that little bit less daunting. Paul had a team of nurses that supported him throughout the five days he spent in hospital recovering after surgery. He says: “They were so kind and helpful. It felt odd discussing such intimate things about myself with the team at first, but they made me feel so comfortable and open.”

The surgery eliminated Paul's cancer. He is now back at work full-time and fills his weekends with trips to the local golf course and family outings.

Read the full story of Paul's treatment and recovery journey.

Circle Health is committed to investing in the latest surgical techniques, offering the best possible outcomes to our prostate cancer patients. 

We are currently the only private hospital group to own a da Vinci X surgical robot outside of London. The revolutionary machine is available at the Park Hospital in the East Midlands, The Alexandra Hospital in Greater Manchester, and Ross Hall Hospital in Glasgow. 

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

They offer world-class treatment to patients not only from nearby areas but also from across the country, who travel to make the most of their expertise.

Pauls prostatectomy story

Paul Jenkins underwent robotic prostatectomy for prostate cancer at The Park Hospital in Nottingham.

Find out how we eliminated his cancer and helped him get his life back on track.

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Do you have questions about prostate cancer treatments?

Mr Ben Sherwood is a consultant urological surgeon specialising in prostate cancer. Here he explains some of the conditions, treatments and concerns with regards to prostate cancer.

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