A laparoscopic radical prostatectomy is a surgical procedure sometimes performed on men to remove the prostate gland. If a man has been diagnosed with prostate cancer, the physician may choose to perform surgery to remove his prostate gland. The laparoscopic procedure is done with surgical instruments and a camera that are inserted through small incisions in the abdomen.
The prostate is a round gland that is located in the lower abdomen behind the pelvic bone and beneath the bladder. It is a nonessential organ that produces the liquid found in semen. Two halves of the prostate surround the urethra, which is the tube that carries urine from the bladder out of the body.
Prostate health can be monitored by measuring levels of prostate-specific antigen (PSA) in blood. If PSA levels in blood are higher than 4 nanograms per milliliter (ng/mL), the patient may be at risk for developing prostate cancer. A digital rectal exam is also part of a typical prostate health assessment; a physician may be able to feel cancerous nodules on the prostate. Some noncancerous conditions of the prostate can lead to elevated PSA levels, so a biopsy of the prostate is necessary to confirm the diagnosis of cancer.
Once the patient has a confirmed diagnosis of prostate cancer, there are various treatment options. If the cancer is confined to the prostate, surgical removal of the prostate is an option. A laparoscopic radical prostatectomy is less invasive than open surgery, generally causing less pain and with a shorter anticipated recovery.
A laparoscopic radical prostatectomy is performed under general anesthesia and typically lasts several hours. The patient is positioned on his back, legs apart. The surgeon inserts a needle into the abdomen to inflate the area with carbon dioxide and makes several incisions in the abdomen to insert trocars, which create ports through which to insert a camera and surgical instruments.
The surgical instruments can be operated by the surgeon or by a robot directed by the surgeon. In either case, the entire prostate is located and removed. The portion of the urethra that runs through the center of the prostate must be removed and the two ends of the urethra reattached. A catheter inserted into the urethra drains urine from the bladder during the recovery period.
Some risks of the laparoscopic radical prostatectomy include loss of sexual function or loss of bladder control. During the procedure, the surgeon may be able to avoid any nerve damage that could interfere with sexual function. Loss of bladder control may be a temporary side effect and bladder control is generally expected to return to normal after a recovery period.
A laparoscopic procedure offers the patient a shorter hospital stay and a shorter recovery time because the incisions it requires are very small. The laparoscopic radical prostatectomy is most successful in treating cancer that is limited to the prostate. If the cancer has spread or metastasized to other tissues, the laparoscopic radical prostatectomy is not normally done.