A prostate cancer diagnosis brings many unfamiliar terms, and radical robotic prostatectomy is often one of them. Understanding what actually happens during the operation can make it feel less daunting. This article explains radical robotic prostatectomy step by step and describes the technical features that set it apart from traditional surgery.
What "radical prostatectomy" means
A radical prostatectomy is an operation to remove the whole prostate gland and some surrounding tissue. It is one of the main treatments for localised prostate cancer, meaning cancer that has not spread beyond the prostate. Historically, it was carried out through a single large incision in the lower abdomen. A radical robotic prostatectomy removes the same tissue through small keyhole incisions, with robotic assistance.
Who controls the robot
It is important to be clear that the robot does not operate by itself. A consultant surgeon sits at a console in the operating theatre and controls every movement of the instruments. The system translates the surgeon's hand movements into smaller, precise movements inside the body. A bedside assistant and the theatre team support the operation throughout, and the anaesthetist looks after you from start to finish.
The operation, stage by stage
- Anaesthetic and positioning. You are given a general anaesthetic and positioned on the operating table, tilted slightly head-down to give a clear view of the pelvis.
- Small incisions. Usually five or six small keyhole incisions are made in the abdomen.
- Instruments and camera. The robotic arms are connected, holding a high-definition camera and specialised instruments.
- Freeing the prostate. The surgeon carefully separates the prostate from the bladder, the rectum and, where possible, the nerves along each side.
- Lymph nodes, if needed. Nearby lymph nodes may be removed if there is a risk the cancer has spread to them.
- Removing the prostate. The prostate and seminal vesicles are placed in a bag and removed through one of the incisions.
- Reconnecting the bladder. The bladder is stitched to the urethra, and a catheter is placed to allow this join to heal.
The operation typically takes a few hours. The removed tissue is then sent to the laboratory for detailed examination. Our guide to understanding results after surgery explains what the report shows.
What makes robotic surgery different
Magnified 3D vision
The surgeon views the operating area in high definition and three dimensions, with significant magnification. This makes it easier to identify small blood vessels, nerves and the boundaries between tissues.
Wristed instruments
The instruments have joints that can bend and rotate further than a human wrist, allowing precise work in the narrow space of the pelvis.
Tremor filtering
The system filters out natural hand tremor, which supports fine, steady movements near delicate structures.
Keyhole access
Smaller incisions mean less disruption to the body, usually with less pain, lower blood loss and a shorter hospital stay than open surgery. Our comparison of robotic and open surgery sets out the differences.
What it means for recovery
Most men go home within one to two days, with the catheter usually removed after one to two weeks. The precision of robotic surgery supports nerve-sparing where it is safe, which can help recovery of continence and erections, although results vary between individuals. Our recovery timeline gives a week-by-week guide.
Is it right for you?
Radical robotic prostatectomy is often recommended for men with localised cancer who are in good general health. However, active surveillance and radiotherapy are also effective options for many men. NHS information on treatment and Cancer Research UK explain the alternatives. Our robotic prostatectomy page describes the operation Professor Dasgupta performs.
To discuss whether this operation is the right treatment for you, please contact the clinic to arrange a consultation.