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, ureter (tube), bladder, prostate, and urethra (the second tube).
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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 cancer
—to repair an abnormality of the kidney and nearby ureter, which is a tube that leads from the kidney to the bladder
—to remove all or part of the bladder to treat bladder cancer
—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
Complications are rare, but no procedure is completely free of risk. If you are planning to have a robot-assisted urologic procedure, your doctor will review a list of possible complications, which may include: 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 (ECG, EKG)Intravenous pyelogram (IVP)Retrograde pyelogramKidneys, ureter, bladder (KUB)UltrasoundCT scanMRI scanCystoscopy
Leading up to the procedure:
Talk to your doctor about your medications. You may be asked to stop taking some medicines up to one week before the procedure, like:
Anti-inflammatory drugs such as ibuprofenBlood thinnersAnti-platelet medicationsTake 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 3D 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 with joystick-like controls and foot pedals. After the tools are removed, sutures or staples will be used to close the surgical area.
About 2-4 hours, depending on the procedure
You will have pain and discomfort during recovery. You will be given pain medication. You may also feel bloated or have pain in your shoulder from the gas used during the procedure. This can last up to three days.
About 1-2 days, depending on the procedure
When you return home, do the following to help ensure a smooth recovery: For some procedures, a urine catheter will be left in place for a while. You will be instructed on how to care for this.If advised by your doctor, take antibiotics. You will need to avoid other medications. Talk to your doctor about which ones.While resting, keep your legs elevated. Move your legs to avoid blood clots.Wash the incisions with mild soap and water.Ask your doctor about when it is safe to shower, bathe, or soak in water.Drink plenty of fluids. This will help to clear your bladder.
. Eat a high
diet. Drink plenty of water. Use stool softeners if necessary.
Avoid caffeinated beverages, alcohol, spicy foods, or other food or drink that might upset your stomach, intestines, or urinary tract.Resume normal activities soon. This will promote healing.Limit certain activities, such as driving, working, and doing strenuous exercise, until you have recovered.Be sure to follow your doctor's instructions.
Total recovery usually takes about 3-6 weeks.
After you leave the hospital, contact your doctor if any of the following occurs: Catheter stops draining or falls out—if you had a catheter placedDifficulty 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 diarrheaCough, shortness of breath, or chest painPain and/or swelling in your feet, calves, or legsOther worrisome symptoms
In case of an emergency, call for medical help right away.
Carmack AJ, Siddiq FM, Leveillee RJ. Novel use of da Vinci Robotic Surgical System: removal of seminal vesicle cyst in previously dissected pelvis.
Passerotti CC, Diamond DA, Borer JG, Eisner BH, Barrisford G, Nguyen HT. Robot-assisted laparoscopic ureteroureterostomy: description of technique.
Takacs EB, Kobashi KC. Minimally invasive treatment of stress urinary incontinence and vaginal prolapse.
Urologic Clinics of North America
Last reviewed July 2013 by Marcin Chwistek, MD; 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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