Robot-Assisted Urologic Procedures
Definition
A robot-assisted urologic surgery is when a doctor guides small robotic arms through tiny incisions to do the surgery. It allows for greater range of motion than regular surgery.
From top to bottom: Kidneys, ureters, bladder, prostate, and urethra.
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Reasons for Procedure
This method is used when surgery needs to be precise. Examples of robot-assisted urologic surgeries are:
- Prostatectomy —removes part or all of a prostate gland to treat prostate cancer
- Pyeloplasty —repairs problems with the kidney and the tube that leads from the kidney to the bladder
- Cystectomy —removes all or part of the bladder to treat bladder cancer
- Nephrectomy —removes all or part of the kidney to treat kidney cancer, kidney stones, or kidney disease
- Ureteral reimplantation—disconnects and reinserts the tube from the bladder to keep urine from flowing backwards from the bladder into the kidneys
The benefits of this type of surgery are:
- Less blood loss
- Lower risk of infection
- Less scarring
- Less trauma to the body
- Faster recovery
- Less time in the hospital
Possible Complications
Problems from robotic-assisted surgeries are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:
- Excess bleeding
- Problems from anesthesia, such as wheezing or sore throat
- Infection
- Damage to nearby organs or structures
- The need to switch to traditional surgery types, such as traditional laparoscopic or open surgery
Things that may raise the risk of problems are:
- Smoking
- Chronic diseases, such as diabetes or obesity
- Alcohol use disorder
What to Expect
Prior to Procedure
The surgical team may meet with you to talk about:
- Anesthesia options
- Any allergies you may have
- Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
- Fasting before surgery, such as avoiding food or drink after midnight the night before
- Arranging for a ride to and from surgery
- Tests that will need to be done before surgery, such as imaging tests
Anesthesia
General anesthesia will be used. You will be asleep.
Description of the Procedure
Several small incisions will be made in the belly. A needle may be used to inject gas into the area. This will make it easier to see inside the body. A scope with a small camera on the end will be passed through one of the incisions. The camera will display the area on a video screen. Next, robotic arms holding tools will be inserted through the holes.
While sitting nearby, the doctor will use lenses to look at a magnified 3-D image of the inside of the body. Another doctor will adjust the camera and tools. The robotic arms and tools will be guided by the surgeon. When the surgery is done, the tools will be removed. Stitches or staples will be used to close the incisions. Bandages will be used to cover them.
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How Long Will It Take?
About 2 to 4 hours. It depends on the type of surgery.
Will It Hurt?
It depends on the surgery, but pain and swelling are common in the first 2 weeks. Medicine and home care can help.
Average Hospital Stay
The usual length of stay is about two days. If you have any problems, you may need to stay longer.
Post-procedure Care
At the Care Center
Right after the procedure, the staff may give you medicine to treat pain.
During your stay, staff will take steps to lower your chance of infection, such as:
- Washing their hands
- Wearing gloves or masks
- Keeping your incisions covered
You can also lower your chance of infection by:
- Washing your hands often and reminding visitors and staff to do the same
- Reminding staff to wear gloves or masks
- Not letting others touch your incisions
At Home
Activities will be limited during recovery. You may need to ask for help with daily activities and delay your return to work. It will take about 3 to 6 weeks to heal.
Call Your Doctor
Call the doctor if you are not getting better or you have:
- Signs of infection, such as fever and chills
- Problems passing urine
- Heavy bleeding or clots in the urine
- Pain, burning, urgency, or increased frequency of urination
- Redness, swelling, increasing pain, excessive bleeding, or discharge from an incision
- Belly swelling or pain
- Constipation, nausea, vomiting, or diarrhea
- Pain and swelling in your feet, calves, or legs
- New or unexpected symptoms
If you think you have an emergency, call for medical help right away.
RESOURCES:
National Institute of Diabetes and Digestive and Kidney Diseases
https://www.niddk.nih.gov
Urology Care Foundation
http://www.urologyhealth.org
CANADIAN RESOURCES:
Canadian Urological Association
http://www.cua.org
The Kidney Foundation of Canada
https://www.kidney.ca
REFERENCES:
Robotic surgery. The Robotic Surgery Center at NYU Langone Medical Center website. Available at: http://robotic-surgery.med.nyu.edu/for-patients/what-robotic-surgery. Accessed August 14, 2020.
Urologic robotic surgery. UC Davis Health website. Available at: https://health.ucdavis.edu/urology/specialties/robotic_surgery. Accessed August 17, 2020.
Last reviewed March 2020 by EBSCO Medical Review Board James P. Cornell, MD Last Updated: 8/17/2020