Robotic surgery in the UK is most closely linked with prostate cancer, and robotic prostatectomy is now the most common way to remove the prostate. The same technology is also used for many other operations on the urinary system. Knowing where it is used can help patients understand their options if they need surgery for another urological condition.
Why urology suited robotics early
Many urological organs sit deep in the pelvis or at the back of the abdomen. These areas are hard to reach with traditional keyhole instruments and often needed large incisions with open surgery. The robot's magnified 3D view and wristed instruments make it easier to work precisely in these confined spaces. Our guide to how the surgical robot works explains these features.
Kidney surgery
Partial nephrectomy: for small kidney tumours, surgeons often aim to remove only the tumour and keep the rest of the kidney. This requires precise cutting and careful stitching of the kidney, which robotic instruments help with. Keeping healthy kidney tissue can help protect long-term kidney function.
Radical nephrectomy: removing the whole kidney, for larger tumours, can also be done robotically in selected cases.
Pyeloplasty: a reconstructive operation for a narrowing where the kidney drains into the ureter. Robotic stitching is particularly helpful here.
The NHS guide to kidney cancer gives background on treatment.
Bladder surgery
Radical cystectomy: for some bladder cancers, the bladder is removed and a new way of storing or draining urine is created. Robotic cystectomy is now offered in many UK centres. The reconstruction can be done inside the body or through a small incision.
Bladder reconstruction: for some non-cancerous conditions, robotic techniques can be used to enlarge or repair the bladder.
The NHS guide to bladder cancer explains when surgery is recommended. As with kidney surgery, the choice between robotic and open cystectomy depends on the patient, the cancer and the experience of the team.
Other urological operations
Robotic surgery may also be used for:
- repairing a damaged or narrowed ureter
- removing the adrenal gland
- some operations for an enlarged prostate. Our article on Aquablation therapy describes a robot-assisted, heat-free treatment.
- lymph node surgery
How recovery compares
Compared with open surgery, the benefits for patients usually include:
- Smaller incisions: several small cuts instead of one large one.
- Less blood loss: helped by the magnified view and precise sealing of vessels.
- Less pain: often meaning fewer strong painkillers.
- A shorter hospital stay: depending on the operation.
- A quicker return to normal activities.
The exact recovery depends on the operation. A partial nephrectomy has a very different recovery from a cystectomy, for example. Your surgical team will explain how long you are likely to stay in hospital, whether you will need a catheter or drain, and when you can expect to return to work and normal activities.
Limits of robotic surgery
Robotic surgery is not right for every patient or every operation. Some men and women may be better suited to open surgery, standard keyhole surgery or non-surgical treatment. Previous operations, general health and the nature of the condition all affect the choice.
Experience matters
As with prostate surgery, results depend on the training and experience of the surgical team. It is reasonable to ask how often a surgeon performs a particular operation robotically, and what their own outcomes are. Complex operations are often concentrated in specialist centres, where teams carry out larger numbers and can offer more experience.
Telesurgery and the future
Robotic systems also make it possible for an expert surgeon to guide or perform surgery from another location. Our article on the UK's first long-distance robotic prostatectomy describes a landmark in this area.
Professor Prokar Dasgupta has helped develop robotic surgery in UK urology for more than two decades. Our robotic prostatectomy page explains his main area of practice. Please contact the clinic to arrange a consultation.