Robotic Radical Prostatectomy for Cancer of the Prostate.

(Robot-Assisted Laparoscopic Radical Prostatectomy. RALP, Da Vinci Prostatectomy)

Robotic Radical Prostatectomy is keyhole surgery for carrying out the complete removal of the prostate for cancer of the prostate. It utilises the latest technology in surgical technique, and represents cutting-edge technology for the treatment of carcinoma of the prostate.

Open surgery is associated with more bleeding, more post operative pain and a longer hospital stay.

Normal keyhole or laparoscopic surgery has a limited range of movements that make complex surgery very difficult.

The Robotic technique adds a wrist to the end of the laparoscopic instruments that allows a full range of movement which makes complex tasks, such as suturing, more straight forward. It also provides for binocular vision which gives a highly magnified three dimensional view of the operation site. The Neuro Vascular Bundle (NVB) passes on the postero-lateral aspect of the prostate. Preserving the nerves requires a precision dissection of the fascial coverings of the prostate to separate the nerves from the capsule of the prostate, without compromising the complete removal of all of the cancer.

The Robot facilitates the accurate removal of the prostate, and in particular allows accurate nerve sparing of the nerves to the penis.
The Robot was developed by the company Intuitive, and is called the Da Vinci Robot. The operating instruments are introduced into the abdomen through small incisions. The surgeon sits at a console in the operating theatre, and operates these instruments with hand controls.

The advantages of the Robot technique over conventional open surgery are:

• Less post-operative pain
• Less blood loss, with a low incidence of blood transfusion
• Shorter hospital stay
• Earlier return to work and normal activities
• The potential for an improved and more accurate nerve sparing procedure and preservation of continence.

Dixon is a fellowship-trained Robotic Surgeon. He spent two years at the University of Toronto, Canada, at Princess Margaret Cancer Centre (the world’s 5th largest cancer centre) and Toronto General Hospital. During this time he also visited the Cleveland Clinic, Ohio, U.S.A.  and the Sun Yet-Sen Memorial Hospital, Guangdong, China to broaden his robotic surgical skills. He uses the latest Da Vinci Xi machine at the Epworth Freemasons Hospital.

Some of the state-of-the-art principles that Dixon follows to spare the nerves to the penis include: 

• Careful meticulous technique
• Nerve sparing procedure by developing the Veil of Aphrodite which is considered to be the optimum method for preserving the erectile nerves to the penis
• Using a cautery-free technique in dissecting the neurovascular bundle

Disclaimer: The information on this website is provided for your general information and is not a substitute for the specific advice of your treating doctor.