Choosing a treatment for prostate cancer can feel daunting. Robotic prostatectomy is one of the most widely used options for localised disease, and it has clear advantages. It also has limitations, and it is not the right choice for every man. Weighing the robotic prostatectomy pros and cons honestly can help you decide whether it suits you.
What the operation involves
A robotic prostatectomy removes the whole prostate through several small incisions. The surgeon controls fine instruments from a console, viewing a magnified 3D image. Despite the name, the robot does not operate on its own; every movement is made by the surgeon. Our robotic prostatectomy page describes the operation in more detail.
The benefits
Precision
Magnified vision and steady, wristed instruments help the surgeon work carefully around the nerves and blood vessels beside the prostate.
Smaller incisions
Several small cuts rather than one large one mean less scarring and usually less pain after surgery.
Less blood loss
Blood loss is generally low, and most men do not need a transfusion. This also helps energy levels recover more quickly after the operation.
Faster recovery
Most men leave hospital within one to two days and return to normal activities within a few weeks. Our recovery timeline sets out the typical milestones.
Support for nerve-sparing
The precision of robotic surgery supports nerve-sparing where it is safe, which can help recovery of continence and erections. Outcomes still vary from man to man.
The limitations
Surgery is not always needed
Some men with low-risk prostate cancer do not need treatment straight away. Active surveillance, with regular PSA tests and scans, can be a safe alternative and avoids the side effects of surgery. Treatment can still be offered later if the cancer shows signs of change.
Side effects remain possible
Robotic surgery reduces some risks but does not remove them. Urinary leakage and erectile difficulties can still occur, particularly in the early months. Our article on erectile function after surgery explains the factors involved.
Results depend on the surgeon
The technology is only as good as the surgeon using it. Experience has a strong influence on results, so choosing an experienced robotic surgeon is essential. Our article on why surgeon experience matters explains why.
Not suited to every stage
If cancer has spread beyond the prostate, other treatments such as radiotherapy or hormone therapy may be more appropriate, alone or in combination.
A major operation
Although less invasive than open surgery, robotic prostatectomy is still carried out under general anaesthetic. Some medical conditions or previous operations need careful assessment first, and recovery still takes several weeks.
Where it fits among your options
NICE guidance on prostate cancer sets out how treatments are matched to different risk groups, and NHS information on treatment summarises each option. Your specialist will consider the stage of the cancer, your general health and your own priorities when advising you.
Questions to ask your specialist
- What are all my treatment options?
- What results could I expect from robotic surgery in my case?
- How experienced are you with this operation?
- What would recovery involve for me?
- What are the main risks and side effects?
The balance for you
For many men with localised prostate cancer, robotic prostatectomy offers effective cancer control with a quicker, more comfortable recovery. Even so, it is not the best choice for everyone. The most important step is a personalised discussion with a specialist who can review your case and help you weigh the options.
If you would like to talk through whether robotic surgery is right for you, please contact the clinic to arrange a consultation with Professor Dasgupta.