Robotic and open prostatectomy both remove the whole prostate to treat localised cancer, and both can achieve effective cancer control in experienced hands. Where they differ most is in recovery. This article compares robotic vs open prostatectomy recovery stage by stage, so that you can see what each might mean for your life in the weeks after surgery.
How each operation is done
Open prostatectomy removes the prostate through a single larger incision in the lower abdomen, using conventional instruments. It has a long history and well-documented results, and it remains suitable for some complex cases.
Robotic prostatectomy uses several small keyhole incisions. The surgeon controls fine instruments from a console, with magnified 3D vision and precise, steady movements. Our earlier comparison of the key differences covers the techniques in more detail.
Recovery compared
Hospital stay
After robotic surgery, most men go home within one to two days. After open surgery, a stay of three to five days is more typical.
Pain
Smaller incisions usually mean less pain after robotic surgery. Men having open surgery often need stronger pain relief for longer, which can affect sleep and mobility in the first days.
Blood loss
Blood loss is generally lower with robotic surgery, and transfusion is rarely needed. This also helps energy levels recover more quickly in the first weeks at home.
Catheter
After either operation, the catheter usually stays in for one to two weeks while the join between the bladder and urethra heals.
Return to daily activities
Many men return to light daily activities within two to three weeks after robotic surgery. After open surgery, this more often takes four to six weeks.
Scarring
Robotic surgery leaves several small scars, while open surgery leaves one longer scar on the lower abdomen. For most men, scarring is a minor consideration compared with recovery and results, but some find the smaller scars reassuring.
Our recovery timeline sets out the weeks after robotic surgery in more detail.
Longer-term outcomes
Cancer control
When performed by experienced surgeons, both approaches achieve comparable cancer control. The stage and aggressiveness of the cancer, and the surgeon's experience, matter more than the method.
Urinary continence
Robotic surgery is often associated with a faster recovery of bladder control, helped by precise reconstruction and nerve-sparing.
Erectile function
Both approaches can preserve the nerves that control erections where it is safe. Recovery may take months to a year or more, depending on age, function before surgery and the extent of nerve-sparing. Professor Dasgupta's SAFE nerve-sparing technique is used during robotic surgery to help protect these nerves.
Risks with both approaches
Both operations carry risks, including bleeding, infection, urinary leakage, erectile difficulties and, rarely, injury to nearby structures. Robotic surgery typically reduces blood loss and tissue trauma, which may lower some complication rates. Our guide to robotic prostatectomy risks explains each in more detail.
Choosing the right approach
The decision depends on your health and anatomy, the size and position of the cancer, your surgeon's experience and the technology available. NHS information on prostate cancer treatment and Cancer Research UK provide independent summaries of the options.
Professor Dasgupta assesses each patient individually and recommends the approach that best balances cancer control with recovery and quality of life. For most suitable patients, that is robotic surgery.
A faster return to normal life
Both approaches treat prostate cancer effectively. For many men, the shorter hospital stay, reduced pain and quicker return to everyday life make robotic surgery the more comfortable choice, particularly when performed by an experienced surgeon.
To discuss which approach would suit you, please contact the clinic to arrange a consultation.