About this page. This is a plain English summary of how the da Vinci robotic system is used during prostate surgery. It does not replace medical advice from your own doctor or specialist.
For full information and references, please read the detailed page.
What the da Vinci system is
The da Vinci is the robotic system used for keyhole prostate surgery. It has two main parts:
- The patient cart, which sits over the patient and holds the camera and instruments.
- The surgeon's console, which sits a few metres away. The surgeon sits at the console and controls everything.
What happens on the day
- You go into the operating theatre and the anaesthetist puts you to sleep.
- The surgeon makes a few small cuts in the abdomen and places little tubes (ports) through them.
- Carbon dioxide gas is gently put into the abdomen through the ports. This creates space to work in. The pressure of the gas is usually higher than the pressure in small veins, which is why bleeding is reduced.
- The robotic instruments and the camera are passed in through the ports.
- The surgeon then leaves the operating table, sits at the console, and operates from there.
What the surgeon sees and does
At the console, the view is in three dimensions, like an IMAX cinema. There are two tiny cameras inside, and the system combines the images so the surgeon can judge depth as well as left and right.
As the surgeon moves the hand controls, the instruments inside the patient copy the movements exactly. The robotic wrists can rotate around tight corners with more degrees of movement than the human wrist.
The image is also magnified about ten times, which lets the surgeon see and work around very small structures, such as the nerves involved in erections.
There is also a fourth arm. With a foot pedal, the surgeon can take control of this arm to hold tissue out of the way - a bit like having an extra pair of hands.
The key steps inside the body
- The prostate is carefully separated from the surrounding structures.
- Where it is safe to do so, the small nerves for erections are gently peeled off the prostate before it is removed.
- The prostate is then taken out through one of the small cuts.
- The bladder and urethra are stitched back together over a catheter. The robot allows this join (anastomosis) to be very precise, which helps reduce later scarring.
Total operating time is usually about 1.5 to 2 hours of robotic time, plus some time for setting up and finishing.
Important things to know
- The robot does not move on its own. The surgeon controls everything. The robot is a tool that copies the surgeon's hand movements.
- The risks of any major prostate operation still apply: bleeding, infection, blood clots, urinary leakage in the early weeks, and changes to erections.
- The surgeon's training, experience, and individual results matter more than the brand of robot.
- Sometimes the operation has to be changed mid-way (for example to open surgery) for safety. This is uncommon but possible.
- This page is general information only. The right operation and surgeon for you should be decided with your own specialist.
What you can do next
- Read the full detailed page with the video.
- Short version: robotic prostatectomy - the operation in plain English.
- Short version: the advantages of the robotic approach.
- Short version: single port robotic surgery - a newer one-incision approach.
- Request a second opinion on a treatment plan.
- Call 02 8382 6980 to make an appointment.