da Vinci Operation

Robot-assisted da Vinci prostatectomy

The radical removal of the prostate is carried out in the case of prostate cancer. The medical implications and the individual steps of the operation are outlined in the following.

In addition, you can find information on the time flow of the da Vinci prostactectomy here.

Indication:

Depending on the aggressivity and size of the tumour in the punch biopsy, it is classified in one of three risk categories ("low", "medium", "strong" aggressivity). Especially in the lower-class risk category, further therapies are also possible for the healing of the tumour (brachytherapy, radiation, active monitoring).
Comprehensive advice on therapy options is provided during our da Vinci consulting hours.

Sequence of the operation:

The operation starts with the setting of the trocars. These are 6 small sleeves that are inserted into the abdomen via cuts that are approx. 1 cm long. The fine da Vinci instruments are inserted via these sleeves.

After this, the prostate and the urinary bladder are prepared.

Then the prostate and the seminal vesicles are detached from the urinary bladder and the spermatic ducts are severed. If the tumour spread enables the preservation of nerves that are important for an erection, the vascular nerve strands are detached from the prostate with high precision, under three-dimensional view and with up to 10-fold magnification and thus preserved.

With the same careful preservation of the sphincter muscle fibres, the prostate is separated from the urethra.

Now the lymph nodes are removed in the minor pelvis. Both the lymph nodes and the prostate with the seminal vesicles are put into a specimen pouch which is withdrawn at the end of the operation via one of the small trocar cuts.

A circular watertight suture of the urinary bladder to the urethra is now applied. A catheter is inserted into the bladder. The small wounds are sutured intracutaneously with biodegradable threads.

The blood loss with this operation technique is low (up to 200 ml).