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Prostate Cancer
Radical prostatectomy by laparoscopic surgery and laparoscopic robotic radical prostatectomy attended by a robot..

The prostate cancer used to be diagnosed when the illness was very advanced and the treatment options were limited. Now a days, the prostate cancer is generally discovered IN EARLY STAGES, and the urologists are able to offer a wide range of treatments being based on the patient's age, his health, the stage and degree of the illness. When the prostate cancer is detected on time, the cure rates are very high. Even with the propagation of the cancer or the reappearance, there are treatments that can improve the survival.

The traditional treatment options include the active surveillance ("vigilant wait"), the surgery to extirpate the prostate gland and the radiotherapy. The modern surgical methods with laparoscopic surgery and robotics are less invasive than the traditional surgery. In young patients; in the IURL we suggest to carry out a prostatectomy because it has been seen that the long term results are excellent. However each patient should be examined individually to determine the treatment.

The most important data usually looked for when a patient has prostate cancer, are:

Gleason Degree or level
The cancer stage
Initial prostate specific antigen
Tissue biopsies that were positive

The opened radical prostatectomy consists on the complete extirpation of the prostate gland, the seminal vesicles and the pelvic lymphatic ganglion, by means of an incision on the pubis to the navel. In the laparoscopic prostatectomy and attended by a robot it is offered a reduction of the loss of blood besides that the recovery of the continence and sexual power is quicker and better. This is the trifecta, to achieve very good results in continence and power without putting at risk the oncologic results. The best results have been obtained with the robotic surgery.


Cáncer de próstata Cáncer de próstata

Previous to the surgery
During the preparatory meeting with the doctor we will check your clinical history, the specific values of prostate antigen, and radiology tests.

You will make a complete physical

It will be carried out a transrectal biopsy if you are suspect of having prostate cancer and after that we will discuss the treatment options

In the case of surgery all the patients are generally hospitalized one day before their surgery for preparation of the intestine

Certain medications should be avoided before the Surgery:
The aspirin, Motrin, Ibuprofen, Advil, Alka Seltzer, E Vitamin, Ticlid, Coumadin, Lovenox, Plavix and some medications for the arthritis can cause hemorrhage and should be avoided one week before the date of the surgery. Tell your prescribing doctor all the medication that you want to take to obtain his approval.
Don't eat neither drink anything after the midnight, the night before the surgery
Only drink clear liquids during a period of 24 hours before the date of your surgery

The surgery
The laparoscopic robot radical prostatectomy with neuropreservation it is a very well established procedure in the IURL and it is carried out with the help of a very experienced team dedicated to laparoscopic surgery including nurses, anesthesiologists, surgery room technicians, many of which many of whom you will find the day of the surgery.

The laparoscopic and robotic surgery has the same anatomical principles of the open surgery, but without the surgeon’s hands enters in the cavity of the patient's body. The main advantages are the magnifying of the operative field with a special lens which makes the surgery more precise and exact. And the offered results are better. The duration of the surgery time during the laparoscopic prostatectomy can vary considerably (1,5 - 3 hours). The loss of blood during the laparoscopic prostatectomy is habitually less than 200 cc. The transfusions are rare.


 Possible risks and complications:
Although these procedures have shown to be very safe, as in any surgical procedure there are risks and potential complications. The security and the rates of complications are similar in comparison with the open surgery. The potential risks include:
Bled
Infection
Lesions of organs
Hernia
The switch to open surgery


What should you expect after the surgery
 During your hospitalization
Immediately after the surgery, you will be taken to the recovery room, and later on transferred to your room of the hospital once you are totally awake and your vital signs are stable .
The duration of the stay in the hospital for most of the patients is of 1-2 days. 
Pain: medications will be administered to control the same one. 

Strolling: One day after the surgery you have to stand up from the bed and give walks supervised by a nurse or a member of your family. The strolling will help to prevent clots formations in the legs.

Constipation / Gas Cramps:
You can experience lazy intestine during several days after the surgery, as consequence of the anesthesia.

All patients go out from the operating room with a probe through the urethra that will remain about 8 days, being removed in the clinic. You will also have drainage in the abdomen, same one that will be removed when you are discharged from the hospital.

Discharge from the hospital
 
The incisions and sutures: the incisions closed with sutures under the skin will be dissolved inside, after 4 to 6 weeks 
The probe is removed after 8 days 
The final result of Pathology is revised and it will be commented with you 
It is important to know that the full control of the urination can even take until one year to completely stabilize after the surgery. Most of the men experience an improvement after 3-6 months. After 6 months, 70% of the patients do not require using pads anymore, 95% are completely continent after one year 
The power recovers in an average of six months, it is sometimes necessary to take medications to improve it and to be able to achieve penetration 
The oncology control is carried out every three months with an appointment and a series of tests 

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