Robotic Adenomectomy for Benign Prostatic Hyperplasia (BPH)
Robotic Adenomectomy for Benign Prostatic Hyperplasia (BPH)
Benign prostatic hyperplasia (BPH) is a common condition in older men. The enlargement of the prostate puts pressure on the urinary tract, causing an obstruction in the bladder outlet. This condition manifests itself with symptoms such as difficulty urinating, frequent urination, waking up at night to urinate, and inability to fully empty the bladder. Treatment options include medication, minimally invasive methods, and surgery. Surgical treatment is recommended, especially for larger prostates.
Robotic adenomectomy (RALA) is a minimally invasive surgical procedure used to treat BPH. It is less invasive than traditional open surgery, shortens recovery time, and has a lower risk of complications.
What is Adenomectomy?
Adenomectomy is the surgical removal of enlarged adenomatous (benign) tissue of the prostate. In the case of benign prostatic hyperplasia, it aims to remove only the enlarged tissue, preserving the outer capsule of the prostate. As an alternative to traditional open surgery, laparoscopic and robot-assisted laparoscopic methods have been developed.
Purpose of Robotic Adenomectomy
RALA aims to relieve symptoms caused by the enlargement of the prostate pressing on the bladder or urethra. This procedure restores urine flow and improves bladder emptying. Thanks to the advantages of robotic surgery, more precise surgical manipulation can be performed and less damage is done to surrounding tissues.
How is Robotic Adenomectomy Performed?
- Anesthesia:
The procedure is performed under general anesthesia, so the patient is not awake during the procedure and does not feel pain.
Surgical Preparation:
Several small incisions are made in the abdomen to insert robotic surgical instruments and a camera.
- Reaching the Prostate:
The surgeon reaches the enlarged prostate tissue using robotic arms. The robotic system precisely transfers the surgeon’s movements to the prostate tissue.
- Removal of Enlarged Prostate Tissue:
The outer capsule of the prostate is preserved, while the enlarged internal tissue is removed. This is the part of the tissue that presses on the bladder and blocks the urinary tract.
The prostate capsule is preserved and the removed tissue can be taken for pathological examination.
- Bleeding Control:
After the enlarged prostate tissue is removed, the surgeon controls bleeding. With the help of the robot, blood vessels can be closed with precision.
5.Closing the Incisions:
The robotic instruments are removed and the surgical incisions are closed. The patient begins the recovery process after surgery.
Advantages of Robotic Adenomectomy
- Minimally Invasive Approach:
Since small incisions are made, recovery time is shorter and post-operative pain is less compared to open surgery.
- Less Bleeding:
Robotic surgery allows for more precise control of blood vessels, reducing bleeding.
- Faster Recovery:
Patients can generally be discharged sooner and return to daily activities more quickly.
- Improved Visual Field:
The high-resolution 3D imaging provided by the robotic system allows the surgeon to better view the operating area, which increases surgical precision.
- Less Damage to Surrounding Tissues:
Robotic surgery reduces the risk of damage to the tissues surrounding the prostate. Urinary continence and sexual functions are particularly preserved.
Possible Complications
Robot-assisted laparoscopic adenomectomy is generally a safe procedure, but as with any surgical procedure, complications can occur. These complications include:
- Bleeding:
Although robotic surgery reduces the risk of bleeding, bleeding may occur during or after surgery due to the prostate’s high vascularity. In rare cases, a blood transfusion may be required.
- Infection:
There is a risk of infection in the surgical area. In this case, antibiotic treatment may be required.
- Urinary Leakage (Incontinence):
After prostate removal, some patients may experience temporary urinary incontinence. This usually improves over time, but in rare cases it can be long-term.
- Erection Problems:
If the nerves are affected, erection problems (erectile dysfunction) may occur. The aim is to protect the nerves during robotic surgery, but there is still a risk.
- Retrograde Ejaculation:
Prostate surgery that affects the urethra and bladder can cause retrograde ejaculation, which means that semen flows into the bladder. This is usually permanent and can affect sexual performance.
- Bladder Injury:
Because of the prostate’s close proximity to the bladder, there is a risk of injury to the bladder tissue. When the bladder is damaged, surgical repair may be necessary.
- Urethral Stricture:
A stricture may develop in the urethra (urine tract). This can make it difficult to pass urine and may require further interventions.
Robotic Adenomectomy for Benign Prostatic Hyperplasia (BPH)
Benign prostatic hyperplasia (BPH) is a common condition in older men. The enlargement of the prostate puts pressure on the urinary tract, causing an obstruction in the bladder outlet. This condition manifests itself with symptoms such as difficulty urinating, frequent urination, waking up at night to urinate, and inability to fully empty the bladder. Treatment options include medication, minimally invasive methods, and surgery. Surgical treatment is recommended, especially for larger prostates.
Robotic adenomectomy (RALA) is a minimally invasive surgical procedure used to treat BPH. It is less invasive than traditional open surgery, shortens recovery time, and has a lower risk of complications.
What is Adenomectomy?
Adenomectomy is the surgical removal of enlarged adenomatous (benign) tissue of the prostate. In the case of benign prostatic hyperplasia, it aims to remove only the enlarged tissue, preserving the outer capsule of the prostate. As an alternative to traditional open surgery, laparoscopic and robot-assisted laparoscopic methods have been developed.
Purpose of Robotic Adenomectomy
RALA aims to relieve symptoms caused by the enlargement of the prostate pressing on the bladder or urethra. This procedure restores urine flow and improves bladder emptying. Thanks to the advantages of robotic surgery, more precise surgical manipulation can be performed and less damage is done to surrounding tissues.
How is Robotic Adenomectomy Performed?
- Anesthesia:
The procedure is performed under general anesthesia, so the patient is not awake during the procedure and does not feel pain.
Surgical Preparation:
Several small incisions are made in the abdomen to insert robotic surgical instruments and a camera.
- Reaching the Prostate:
The surgeon reaches the enlarged prostate tissue using robotic arms. The robotic system precisely transfers the surgeon’s movements to the prostate tissue.
- Removal of Enlarged Prostate Tissue:
The outer capsule of the prostate is preserved, while the enlarged internal tissue is removed. This is the part of the tissue that presses on the bladder and blocks the urinary tract.
The prostate capsule is preserved and the removed tissue can be taken for pathological examination.
- Bleeding Control:
After the enlarged prostate tissue is removed, the surgeon controls bleeding. With the help of the robot, blood vessels can be closed with precision.
5.Closing the Incisions:
The robotic instruments are removed and the surgical incisions are closed. The patient begins the recovery process after surgery.
Advantages of Robotic Adenomectomy
- Minimally Invasive Approach:
Since small incisions are made, recovery time is shorter and post-operative pain is less compared to open surgery.
- Less Bleeding:
Robotic surgery allows for more precise control of blood vessels, reducing bleeding.
- Faster Recovery:
Patients can generally be discharged sooner and return to daily activities more quickly.
- Improved Visual Field:
The high-resolution 3D imaging provided by the robotic system allows the surgeon to better view the operating area, which increases surgical precision.
- Less Damage to Surrounding Tissues:
Robotic surgery reduces the risk of damage to the tissues surrounding the prostate. Urinary continence and sexual functions are particularly preserved.
Possible Complications
Robot-assisted laparoscopic adenomectomy is generally a safe procedure, but as with any surgical procedure, complications can occur. These complications include:
- Bleeding:
Although robotic surgery reduces the risk of bleeding, bleeding may occur during or after surgery due to the prostate’s high vascularity. In rare cases, a blood transfusion may be required.
- Infection:
There is a risk of infection in the surgical area. In this case, antibiotic treatment may be required.
- Urinary Leakage (Incontinence):
After prostate removal, some patients may experience temporary urinary incontinence. This usually improves over time, but in rare cases it can be long-term.
- Erection Problems:
If the nerves are affected, erection problems (erectile dysfunction) may occur. The aim is to protect the nerves during robotic surgery, but there is still a risk.
- Retrograde Ejaculation:
Prostate surgery that affects the urethra and bladder can cause retrograde ejaculation, which means that semen flows into the bladder. This is usually permanent and can affect sexual performance.
- Bladder Injury:
Because of the prostate’s close proximity to the bladder, there is a risk of injury to the bladder tissue. When the bladder is damaged, surgical repair may be necessary.
- Urethral Stricture:
A stricture may develop in the urethra (urine tract). This can make it difficult to pass urine and may require further interventions.
Post-Operative Recovery Process
- Hospital Stay:
After the surgery, patients usually stay in the hospital for 1-2 days. Since it is a minimally invasive method, the hospital stay is shorter than open surgery.
- Urinary Catheter:
A urinary catheter is usually used for several days after surgery. The catheter is inserted into the bladder to allow urine to flow and remains in place until the patient’s bladder heals.
- Pain Management:
Postoperative pain is usually minimal and can be controlled with painkillers.
- Return to Normal Activities:
Patients can usually return to their normal daily activities within a few weeks, but it is recommended that strenuous physical activity be avoided.
- Full Recovery:
The exact recovery time may vary from person to person, but the patient is usually fully recovered within 4-6 weeks.
Conclusion
Robot-assisted laparoscopic adenomectomy is an effective method for treating benign prostatic hyperplasia (BPH). This minimally invasive procedure offers a faster recovery and fewer complications than traditional open surgery. The precision and high-resolution imaging provided by robotic surgery allow for the safe removal of enlarged prostate tissue. However, as with any surgical procedure, this procedure carries risks and complications. The surgeon’s experience plays a critical role in reducing these complications, such as sexual function and urinary control.