Laser Prostate (TURP) Surgery in India

Minimally Invasive Laser Prostrate surgery, also known as Laser Prostatectomy or TURP surgery or Transurethral Resection of Prostrate, is a procedure used to remove the enlarged portion of prostate gland. The procedure involves removal of the section of the prostate that is blocking urine flow.

TURP is one of the most effective options for treating an enlarged prostate, a condition also known as benign prostatic hyperplasia (BPH).

Conventional vs Laser Prostatectomy / TURP:

The Laser TURP procedure is much more advanced & beneficial than the conventional procedure. The differences in the two are:

•    For the conventional TURP, the resectoscope, a combined visual and surgical instrument is used, whereas the Laser procedure involves use of advanced laser energy to cut excess gland, thus there is no loss of blood & shorter hospitalization is required
• 
   
  
  Blood thinning agents have to be stopped a week to 10 days before the procedure for conventional TURP, which puts the heart at risk, whereas the laser TURP is done with the blood thinning agents on board, which is highly beneficial for cardiac patients.
• 
   Conventional TURP allows tissue removal at only 1gram/min, whereas laser can vaporize tissue as fast as 3-4 grams/ min.
•   
  For prostates larger than 100gm, open surgery is required in case of conventional TURP, whereas lasers can effectively perform surgery in such large prostate cases

Advantages of Laser TURP:

1. Safer & Faster
2. No blood loss
3. Shorter hospital stay & faster recovery

• Highly beneficial for
•    Patients on blood thinning agents like heparin, aspirin, clopidegrol etc.
•    Patients with kidney dysfunction
•    Patients whose prostate gland size more than 60 gm
•    Patients who are at poor risk for anesthesia
•    Patients with cardiac complications or who have undergone joint replacement surgery

Most Advanced Robotic Prostate Cancer Surgery in India

Most Advanced Robotic Surgery for Prostate Cancer in India

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Advantages of Robotic prostatectomy

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• Minimal Bleeding Faster return to normal daily activities .

• Reduced hospital stay Significantly less pain and scarring

• Lower blood transfusion rates

• Improved preservation of physical appearance.

• Three (3) D vision enables surgeon to perform Prostate excision with Cancer.

• Lower blood transfusion rates

• Control without risk of Post Surgery Continence (control over urinary and fecal discharge) and causing Impotency

Scope of Robotic assisted Laparoscopic surgery in Urology

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• Prostate Cancer- Robotic Radical Prostatectomy

• Pelvi-Ureteric Junction (PUJ) Obstruction- Robotic Pyeloplasty

• Kidney Tumors- Robotic Partial Nephrectomy

• Bladder Cancer- Radical Cystectomy

• Ureteric Reimplantation

• Pelvic Tumor Excision

Robotic surgery involves use of the da Vinci robotic surgical unit in performing complex surgical procedures such as prostatectomy (removal of the prostate gland for cancer). Originally developed for space and military uses, this advanced technology allows the operating surgeon to sit behind a console and control the robot that is next to the patient to perform surgery.

This technology allows the surgeon to operate with very small and precise instruments under a 3 dimensional (3-D) vision, which is magnified up to 10 times. This is achieved by inserting the camera and the instruments into the patient’s body through small cuts (incisions) ranging from 5 – 12 mm in size.

Da Vinci Master Slave Robotic System

The surgical application of robotic systems is one of the most exciting and significant technological developments of this century; its future implications are incalculable.Huge strides have been made in the field of closed operations in the past 10 years and the use of robotic systems has emerged as the principle solution to technical limitations

The use of robotic surgical systems has numerous advantages. Whereas modern laparoscopic systems give only

 a two-dimensional vision, robotic systems give the surgeon a three-dimensional field of vision and depth, provide arms that, unlike the human hand, never tire and permit an unprecedented continuityin operations. Since robotic systemsexceed even the human hand’s freedom and facility of movement, far greater delicacy and dexterity is achieved. Modern robotic systems fall into three categories; active, semi-active and master-slave.But the most commonly used are master-slave systems distinguished by the surgeon’s absolute control of the robot via a remote control console.

The Da Vinci is a sophisticated master-slave robot that incorporates 3-D high definition visualization, scaling of movement, and wristed instrumentation. The operations with the Da Vinci System are performed with no direct mechanical connection between the surgeon and the patient. The surgeon is working a few feet away from the operating table, while seated at a computer console with a three-dimensional view of the operating field.

Robotic Prostatectomy, also known as Robotic surgery for prostate cancer or da Vinci Prostatectomy is a minimally invasive surgery that is now the preferred approach for removal of the prostate in those diagnosed with organ-confined prostate cancer. The da Vinci Prostatectomy may be the most effective, least invasive prostate surgery performed today. Though any diagnosis of cancer can be traumatic, the good news is that if your doctor recommends prostate surgery, the cancer was probably caught early. And, with da Vinci Prostatectomy, the likelihood of a complete recovery from prostate cancer without long-term side effects is, for most patients, better than it has ever been.

The operation is performed using the daVinci Surgical system and 3-D endoscopic and wristed instruments inserted through 5-6 small incisions across the mid-abdomen

Prostate Surgery in India - Radical Prostatectomy Surgery

Radical Prostatectomy Surgery in India

A radical prostatectomy is a common operation for treating prostate cancer. It used to be called total prostatectomy. This means using surgery to remove all of the prostate gland through a cut in your abdomen or the area between the testicles and the back passage (perineum). The aim of this type of surgery is to cure the cancer. Your surgeon may suggest radical prostatectomy if

·     Your cancer has not spread outside your prostate

·     You are younger, rather than older, and have a high grade tumour

HOW RADICAL PROSTATECTOMY IS DONE

A radical prostatectomy is carried out by specialist surgeons. They take out the whole prostate gland with the aim of getting rid of all the cancer. The surgeon makes a cut in the abdomen (retropubic) or between the testicles and the back passage (perineal). This operation is called open prostatectomy. As well as the prostate gland, the surgeon also removes the surrounding tissues and the tubes that carry semen (seminal vesicles). They then close the wound.

Laparoscopic prostatectomy (keyhole surgery)

Often, a radical prostatectomy is done using keyhole (laparoscopic) surgery. The surgeon uses a tube with a light and eyepiece to look inside the body. They fill the abdomen with carbon dioxide gas so they can see the prostate clearly. A tiny video camera gives a magnified view of the prostate gland on a video screen. The surgeon cuts away the prostate gland from the surrounding tissues and puts it in a small bag before removing it through one of the cuts in the abdomen. The main difference with this surgery is that you won't have a big wound in your abdomen afterwards. Instead you have several small cuts.

 laparoscopic surgery is as good at treating prostate cancer as open surgery. Men also lose less blood, have less pain, and spend less time in hospital. Most men also recover and go back to normal activities more quickly than with open radical prostatectomy surgery. Two of the most common side effects of prostatectomy are problems with control over when to pass urine (urinary incontinence) and inability to have an erection (impotence). There doesn’t seem to be any difference in the number of men who have these side effects after open prostatectomy or after laparoscopic prostatectomy.

What are the Benefits and Risks of Radical prostatectomy?

If you're young and in good health, the short-term risks of this surgery are low. The hospital stay is usually 2 to 3 days, with the catheter left in place for 2 to 3 weeks. You're usually able to go back to work in about 1 month. You shouldn't have severe pain with this surgery. Most men regain bladder control a few weeks to several months after the surgery. The main advantage of surgery is that it offers the most certain treatment. That is, if all of the cancer is removed during surgery, you are probably cured. Also, the surgery provides your doctor with accurate information about how advanced your cancer is, since the nearby lymph nodes are taken out along with the tumor. Surgery does have risks. The main risks of radical prostatectomy are incontinence (loss of bladder control) and impotence (loss of the ability to get or keep an erection long enough to have sex). Most bladder and impotence problems improve with time.

Advanced Prostate Cancer Surgery - Best Robotic Prostate Surgery Hospital in India

Robotic laparoscopy prostatectomy  in India

Robotic laparoscopyprostatectomy offers several advantages. Although experts do not agree as to whether robotic or open surgery is best, the majority of prostate cancer surgeries  are being done with the laparoscopic/robotic approach, particularly at high volume medical centers that specialize in prostate cancer treatment. The post-operative goals for treating prostate cancer are the same regardless of whether the operation is done with an open or laparoscopic approach.

Less Scaring

The first advantage to robotic surgery is that it is an application of advance technology and is minimally invasive. Instead of having a 5 or 6” incision to the skin and abdominal fascia (See image below, left), patients have a series of small “band-aid” incisions. (On right) 

A Shorter Hospital Stay

With smaller incisions, the postoperative pain is significantly less, which means your length of hospitalization is shorter - as is the time to return to usual activity.

After the laparoscopic/robotic prostatectomy patients typically do not require an inpatient hospital stay over one night. Surgery is done in the morning and they typically go home after lunch on the first operative day.

Comparatively, after the open prostatectomy patients spend at least two nights in the hospital primarily for pain control, nausea and difficulty getting out of bed and getting back to an activity level that would be appropriate for them to be discharged home.

Less Drugs, More Blood

Patients' need for postoperative pain medicine and narcotics is also greatly reduced after the laparoscopic/robotic approach compared to open surgery.

Another advantage to robotic surgery is decreased intraoperative blood loss. During traditional open surgery, it is not at all uncommon for patients to lose between 600 cc and 1000 cc of blood intraoperatively given the intense vascularity of the prostate and its surrounding tissues. This entails some significant risk of intraoperative or postoperative transfusion (and secondarily the attendant risk of transfusion) among these patients.

During robotic/laparoscopic prostatectomy, blood loss is usually 200 cc or less, which is very minimal and has a negligible risk of needing a transfusion. This is likely a minor difference as the transfusions are quite safe. However, the small difference among treatment approaches may be quite important to some patients.

Postoperative Catheterization

The third advantage of robotic surgery over open surgery is a reduction in the required postoperative catheterization time. After open surgery, foley catheters are left to drain the urine for usually two or more weeks. After the robotic approach, the catheter typically remains in place 5 to 7 days. The reason for this difference is unclear but may be related to the increased precision and visibility the robotic approach offers and also maybe that a running anastamosis (bringing the bladder neck and urethral sphincter back together) may be done in a water-tight fashion compared to the open approach.

Erectile Function

The fourth advantage of robotic prostatectomy is the (at least theoretical) improved ability to preserve the erectile nerves. During an open prostatectomy through an incision on the anterior abdominal wall, the nerves that provide erection are hidden behind the prostate. The approach taken using the surgical robot, enters the abdomen and the robotic arms are positioned posterior to the prostate with the nerves directly in front of the robotic/laparoscopic camera. In this way, the nerves maybe preserved, primarily because the anatomy can be seen more clearly compared to open surgery.

In addition, the decreased blood loss of the robotic approach improves the intra-operative visibility. As you can imagine, attempting to preserve delicate nerve structures can be quite challenging in the pool of blood versus in a relatively dry surgical field that is expected with the laparoscopic/robotic approach.

Robotic Prostate Surgery 

 Usually in conventional approach, surgeons make decisions using tactile and visual cues to identify a phenomenon, which is actually microscopic which is likely to damage nerves or to leave cancer behind. In the Advanced Robotic Technique (ART) surgeons uses a sophisticated mastr slave robot that incorporates 3-D high definition vision, scaling of movement and wristed instrumentation that gives him the ability to perform Prostate excision with minimal risk of leaving the cancer behind and also minimal bleeding and post operative risk of incontinence and impotence.

Neither clinical nor imaging tests are sensitive enough to capture a tumour at T3 stage where it has become locally advanced and a risk for spreading to other body parts. Sometimes it is difficult for surgeons to find a precise plane between the cancer and urinary sphincter or the nerves and err on the side of cancer safety leading to incontinence or Impotence Da vinci robot system minimizes side effects thereby greater control for the patient over urinary discharge i.e. continence and return to normal sexual function after the surgery.

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World's Most Advanced Robotic Prostate Surgery in India

Robotic Prostatectomy Surgery in India

Robotic Prostatectomy Surgery

A robotically assisted laparoscopic radical prostatectomy utilizes the da Vinci™ Surgical System. The da Vinci™ System is a computer enhanced, minimally invasive surgical tool controlled by the surgeon.

The patient side cart sits at the bedside and holds the 4 robotic arms. The console is an ergonomically designed device that allows the surgeon’s movements to be translated into action utilizing the robotic arms. The robotic arms utilize EndoWrist™ instruments that have more degrees of freedom and precision than the human wrist.

How is Robotic Prostatectomy Surgery Performed

A robotic prostatectomy is performed through small laparoscopic ports. Typically, five ½ to 1 inch keyhole incisions are made in the abdomen for introduction of the laparoscopic ports. The traditional surgical approach uses a larger incision from just below the umbilicus to the pubic bone. The abdomen is inflated with carbon dioxide gas to create a surgical working space. The surgeon operating the robot controls the camera and 3 separate mechanical arms inserted through the laparoscopic ports. The surgeon at the bedside works through the 5th port providing exposure and introducing and removing suture and surgical clips.

In The surgical team then removes the lymph nodes and the prostate and reconstructs the urinary tract in a manner similar to the traditional open approach.

Who is the Candidate for Robotic Prostatectomy Surgery?

• Most men with localized prostate cancer are candidates for Robotic prostatectomy surgery.

• The ideal candidate for robotic prostatectomy is a younger man in good physical health with little co-morbidity, a small prostate, and a lower-grade, low-volume tumor.

Generally, men with Gleason scores of 8, 9, or 10, and/or advanced stage T3-T4 disease would not be considered due to risk of cancer extension beyond the prostate.

What is the Success Rate of Robotic Prostatectomy Surgery?

Robotic prostatectomy surgery has the highest success rate among all prostate cancer treatment options. Success rates for a robotic prostatectomy can range from 30 - 98%. Studies have shown success rates between 80 to 98%. The experience of the surgeon performing the surgery is an important fact, i.e. surgeons have greater success and lower complications rates if they routinely perform the procedure.

Advantages of Robotic prostatectomy 

• Minimal Bleeding Faster return to normal daily activities .

• Reduced hospital stay Significantly less pain and scarring

• Lower blood transfusion rates

• Improved preservation of physical appearance.

• Three (3) D vision enables surgeon to perform Prostate excision with Cancer.

• Lower blood transfusion rates

• Control without risk of Post Surgery Continence (control over urinary and fecal discharge) and causing Impotency

What is Da Vinci Master Slave Robotic System?

Da Vinci master slave robotic system is used to completely eradicate cancer with minimal side effects for treating Prostate Cancer. Through this system a minimally invasive robot assisted radical prostatectomy technique has been developed in which doctors evolved a unique sequence of surgical steps.

The Da Vinci is a sophisticated master-slave robot that incorporates 3-D high definition visualization, scaling of movement, and wristed instrumentation.

The operations with the Da Vinci System are performed with no direct mechanical connection between the surgeon and the patient. The surgeon is working a few feet away from the operating table, while seated at a computer console with a three-dimensional view of the operating field

About MyMedOpinion.com

MyMedOpinion affiliated  Best hospitals in India provide an medical opinion from experienced surgeons and the treatment cost includes companion stay  , surgeon fee, medicines and consumables, nursing care, patient's food and airport pick up & drop etc. etc. We offer free, no obligation assistance to international patients to find world class medical treatment in India. We offer support and services to facilitate the care you require. We can help you find the best hospital in India

Send us a Medical Report to Get FREE Medical Opinion from India's Top Doctors

MyMedOpinion.com  is the hub of Surgeons and specialists for major diseases. We give you a chance to speak to our doctors and discuss your health issues directly. 

Email Us: Free@mymedopinion.com  Call Us: +91-7503537224