Prostate Cancer: Laparoscopic Prostate Surgery
The word laparoscopy means to look inside the abdomen with a special camera or scope. Surgery performed with the aid of these cameras is known as keyhole, porthole, or minimally invasive surgery.
Traditional surgery requires a long incision (cut) down the center of the abdomen and a lengthy recovery period. Laparoscopic surgery eliminates the need for this large incision. As a result, you may have less pain and scarring after surgery, faster recovery, and less risk of infection.
Laparoscopic prostate surgery involves five small (5 to 10 millimeters) incisions (or portholes), one just below the belly button and two each on both sides of the lower abdomen. Carbon dioxide is passed into the abdominal cavity through a small tube placed into the incision below the belly button.
This gas lifts the abdominal wall to give the surgeon a better view of the abdominal cavity once the laparoscope is in place. The surgeon is then guided by the laparoscope, which transmits a picture of the prostate onto a video monitor.
Laparoscopy is a relatively new technique for prostate removal but looks promising. Men who undergo this technique have less blood loss, less need for pain medication, shorter hospital stays, quicker return to regular meals and activities, early removal of urethral catheters (tubes inserted through the penis to drain urine from the bladder), and a quicker recovery.
Laparoscopy appears to treat the prostate cancer as effectively as surgeries done with a large incision.
What Are the Advantages of Laparoscopy?
As is the case with other minimally invasive procedures, laparoscopic prostate removal has significant advantages over traditional surgery:
- Laparoscopy can shorten your hospital stay to one or two days. About 50% of men are discharged one day after surgery. (The length of stay depends on how quickly you recover and the extent of the surgery).
- There is much less bleeding during the operation.
- You are less likely to need prescription painkillers after you leave the hospital. Patients often need nothing more than Tylenol.
- At your follow-up appointment one week after surgery, the tube, or catheter, draining your bladder will be removed if there are no signs of other problems. Occasionally, the catheter remains in place for another week, as with conventional surgery.
- About 90% of patients can return to work or resume full activity in only two to three weeks.
Am I Eligible For This Surgery?
You are eligible if you have prostate cancer that has not spread outside the prostate and is not very aggressive, as well as a PSA test less than 10. You are not eligible if you have had previous open or laparoscopic pelvic surgery, even for another reason. You are also not eligible if you have a history of hormone treatment (androgen deprivation therapy), which reduces the size of the prostate tumor.