A doctor guides robotic arms to do urologic surgery. This is done through several tiny keyhole incisions.
Male Genital and Urinary Systems
From top to bottom: Kidneys, ureters, bladder, prostate, and urethra.
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Examples of urologic surgeries that have been successfully done using this technique include: Prostatectomy—to remove part or all of a prostate gland found to contain prostate cancerPyeloplasty—to repair an abnormality of the kidney and nearby ureter, which is a tube that leads from the kidney to the bladder
Cystectomy—to remove all or part of the bladder to treat bladder cancer
Nephrectomy—to remove all or part of the kidney because of kidney cancer, kidney stones, or kidney disease
Ureteral reimplantation—to disconnect and reinsert the ureter from the bladder to keep urine from flowing backwards from the bladder into the kidneysProcedures requiring fine dissection and suturing such as reconnection of the ureter
Compared to more traditional procedures, robotic-assisted surgery may result in: Less scarringReduced recovery timesLess risk of infectionLess blood loss
to the body
Shorter hospital stayFaster recovery
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like: Damage to nearby organs or structuresInfectionBleedingAnesthesia-related problems
The need to switch to traditional surgical methods such as
or open surgery
Some factors that may increase the risk of complications include: Pre-existing heart or lung conditionIncreased ageDiabetesObesitySmokingExcessive alcohol intakeUse of certain medications
Be sure to discuss these risks with your doctor before the procedure.
Depending on the reason for your surgery, your doctor may do the following: Physical examBlood tests and urine testsElectrocardiogram
Retrograde pyelogramX-ray of kidneys, ureter, bladder
UltrasoundCT scanMRI scanCystoscopy
Leading up to the procedure: Talk to your doctor about your medications. You may be asked to stop taking some medications up to 1 week before the procedure.Take antibiotics if instructed.Follow a special diet if instructed.Shower the night before using antibacterial soap if instructed.Arrange for someone to drive you home from the hospital. Also, have someone to help you at home.Eat a light meal the night before. Do not eat or drink anything after midnight.
will be used. It will block any pain and keep you asleep through the surgery.
Several small keyhole incisions will be made in the abdomen. Carbon dioxide gas will be passed into the area. This will make it easier for internal structures to be viewed. A small camera, called an endoscope will be passed through one of the incisions. The camera will light, magnify, and project the structures onto a video screen. The camera will be attached to one of the robotic arms. The other arms will hold instruments for grasping, cutting, dissecting, and suturing; for example: ForcepsScissorsDissectorsScalpels
Instrument Used in Procedure
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While sitting at a console near the operating table, the doctor will use lenses to look at a magnified 3-D image of the inside of the body. Another doctor will stay by the table to adjust the camera and tools. The robotic arms and tools will be guided by movements of the surgeon. After the tools are removed, sutures or staples will be used to close the surgical area.
About 2-4 hours, depending on the procedure
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications. You may also feel discomfort from the gas used during the procedure. This can last up to 3 days.
About 1-2 days, depending on the procedure
When you return home, do the following to help ensure a smooth recovery: Limit specific activities until you have recovered.Follow your doctor's instructions.
Total recovery usually takes about 3-6 weeks.
It is important for you to monitor your recovery after you leave the hospital. Alert your doctor to any problems right away. If any of the following occur, call your doctor: Catheter stops draining or falls out (if you had a catheter placed)Difficulty urinatingHeavy bleeding or clots in the urinePain, burning, urgency, or increased frequency of urinationSigns of infection, including fever and chillsRedness, swelling, increasing pain, excessive bleeding, or discharge from an incision siteAbdominal swelling or painConstipation, nausea, vomiting, or diarrheaPain and/or swelling in your feet, calves, or legsNew or worsening symptoms
If you think you have an emergency, call for medical help right away.
Bladder cancer—robot-assisted laparoscopic radical or simple cystectomy. University of Chicago website. Available at:
http://www.ucurology.org/procedures/laparoscopic-surgery/__bladder-cancer--robot-assisted-laparoscopic-radical-or-simple-cystectomy. Accessed February 19, 2016.
Carmack AJ, Siddiq FM, et al. Novel use of da Vinci Robotic Surgical System: Removal of seminal vesicle cyst in previously dissected pelvis.
Megaureter. Boston Children’s Hospital website. Available at:
http://www.childrenshospital.org/conditions-and-treatments/conditions/megaureter/overview. Accessed February 19, 2016.
Passerotti CC, Diamond DA, et al. Robot-assisted laparoscopic ureteroureterostomy: description of technique.
J Endourol. 2008;22:581-584.
Robot-assisted laparoscopic radical prostatectomy. Johns Hopkins Medicine website. Available at:
http://urology.jhu.edu/MIS/roboticRRP.php. Accessed February 19, 2016.
Robotic dismembered pyeloplasty. Cleveland Clinic website. Available at:
http://my.clevelandclinic.org/services/urology-kidney/treatments-procedures/robotic-dismembered-pyeloplasty. Accessed February 19, 2016.
Last reviewed February 2016 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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