A laparoscopic prostatectomy is removal of the prostate gland using a technique that involves a special tool called a laparoscope. The laparoscope allows the surgeon to get a clear view of the prostate and surrounding tissue through a monitor. This type of surgery involves several small incisions rather than the one large incision associated with open prostate surgery. The purpose is usually to remove the entire prostate gland to treat prostate cancer. Removal of the entire prostate is called radical prostatectomy. Laparoscopic surgery is much less invasive than traditional surgery, and it requires a shorter hospital stay and recovery time and less prescription pain medication.
Not every patient is a candidate for prostatectomy. He is not eligible if he has already undergone hormone or radiation therapy for prostate cancer treatment. A prostate specific (PSA) level higher than 10 also disqualifies him for prostate removal. Prostatectomy is also not an option if the prostate cancer has spread beyond the prostate, in a process called metastasis.
Several incisions are made during laparoscopic prostatectomy — the first is made just below the bellybutton. This incision is used to blow carbon dioxide into the abdominal cavity, inflating the abdomen to help get a better view of the organs. The laparoscope is inserted into another incision.
Actual removal of the prostate and the rest of the procedure take place through the remaining incisions. A total of five incisions are necessary during laparoscopic prostatectomy. In addition to the first incision below the bellybutton, two more incisions on either side of the first one are made in the lower abdomen.
Recovery time after laparoscopic prostatectomy is usually relatively short. About half of the patients are discharged from the hospital after only one day, but the usual stay is about two days. Most men return to work and regular activity in three weeks.
Patients have to keep a urinary catheter in the urethra for about a week after laparoscopic prostatectomy. The catheter drains urine directly from the bladder and is removed during the follow-up office visit if all is well.
Laparoscopic prostatectomy has proven to be just as affective as open prostatectomy in treating prostate cancer. The effect on sexual function is also thought to be equal. There are a number of methods to help combat impotence after prostate removal, including medication and penile vacuum devices.
Patients might undergo radiation therapy after prostatectomy to ensure that any remaining cancer is destroyed. Radiation therapy also makes androgen deprivation therapy less necessary because it decreases the presence of male sex hormones, particularly testosterone, which could make prostate cancer worse.