Robotic Prostatectomy

Robot-assisted radical prostatectomy (RARP) is a minimally invasive surgical treatment for localised or locally advanced prostate cancer in which the entire prostate gland and seminal vesicles are removed and the bladder is reanastomosed to the urethra. NHS commissioning guidance and major specialist units (UCLH, The Christie, Cambridge University Hospitals) describe it as the standard surgical option for most men requiring prostatectomy, with patients now often discharged the day after surgery instead of the 4-5 days typical of open surgery. The procedure is performed through six small abdominal port incisions with the da Vinci surgical system. The surgeon, seated at a console, controls wristed instruments that translate hand movements into precise, tremor-filtered actions inside the pelvis, while a three-dimensional high-definition camera provides magnified visualisation. Nerve-sparing techniques preserve the neurovascular bundles where oncologically safe, with the aim of maintaining erectile function and continence. Indications include intermediate- and high-risk localised prostate cancer, and selected low-risk disease in younger men. Most patients are discharged within 24-48 hours with a urethral catheter that is removed at 7-14 days. International patients typically remain in-country for about one week for catheter removal and the first wound check. Functional recovery of continence and erectile function continues for up to 12 months. Sources: NHS UCLH, NHS Cambridge University Hospitals, NHS Christie, NHS England commissioning policy, PMC randomised trials.