Robot in Benign Prostatic Enlargement; Robotic Simple Prostatectomy, Robotic Transvesical Prostatectomy, Robotic Transvesical Simple Prostatectomy
What is benign prostatic enlargement?
Benign prostatic enlargement is a disease that usually occurs in advanced ages and the cause of which is unknown. This enlargement of the prostate gland surrounding the urinary canal presses on the urinary canal, causing obstruction in the urinary canal and inability to pass urine easily. For this reason, over time, thickening and sensitization begins due to strain on the bladder muscle. Afterwards, the bladder muscle becomes tired and weak. It cannot completely empty the urine and urine starts to remain in the urinary bladder.
What are the symptoms of benign prostatic enlargement?
Urinating at night and urinating frequently during the day are the most common symptoms. These symptoms cause problems such as lack of sleep in the social life of the person, fatigue, and the search for the toilet where he wants to go. In addition, decreased urine flow rate, delay in starting to urinate, difficulty, feeling of not being able to relax after urination and dripping after urination can be seen.
How is benign prostatic enlargement treated?
In the first stage, medical treatment (drug therapy) is given. If the expected results from the medical treatment cannot be obtained or if the symptoms that have improved despite the treatment recur over time, surgical treatment is considered. In addition, surgical treatment should be planned for patients who have stones in their bladder due to prostate enlargement, who have recurrent bleeding in their urine, who have frequent urinary tract infections, and who need to have a catheter inserted due to inability to urinate at all.
What are the surgical treatments for benign prostaticenlargement?
The patient's age, medications, additional diseases, and prostate size are considered in determining the surgical treatment. There are some classical methods (transurethral resection of the prostate and open prostatectomy) and more recently laser methods for the surgical treatment of prostate enlargement. Open, laparoscopic, or robotic surgery can be considered in prostates weighing more than 100 grams.
How to use a robot in benign prostatic enlargement?
In benign prostate enlargement, robot is a new closed surgical method that provides complete removal of prostate tissue and gives results like open surgery. Here, the robot is used differently from the technique used to remove cancerous tissue in prostate cancer, but the number of robot arms and their locations are similar in the technique used in prostate cancer. Technically, unlike prostate cancer, here the bladder is opened first. The prostate is reached through the bladder neck and the capsule is left and the enlarged tissues of the prostate are removed in one piece, which is called robotic transvesical simple prostatectomy (figures 1 and 2). In appearance, it is almost like leaving the peel of a tangerine and removing the inside.
Figure 1: Transvesical simple prostatectomy technique in benign prostatic enlargement.
Figure 2: Prostate tissues of different patients that I removed with this technique
What are the advantages of robot in benign prostatic enlargement?
In addition to many technological advantages arising from the robotic method itself, there are some additional advantages arising from the surgical technique. Here, since the prostate tissue is peeled off from its capsule and there is no prostate tissue left behind, the patient does not develop benign prostate enlargement again. Again, since there is no prostate tissue left behind patients who have their catheter removed after surgery do not experience a burning sensation while urinating. Since the prostate tissue is removed intact in one piece, it can be examined more easily by pathologists and the possibility of possible malignant structures to be overlooked decreases.
What are the disadvantages of robot in benign prostatic enlargement?
Like all other surgeries, robotic surgery has some risks related to anesthesia. In addition, there may be bleeding, infection, and the possibility of open surgery, but these risks are rare.
Is the doctor important in robotic surgery for benign prostatic enlargement?
As in all urological surgeries, it is very important that the surgeon performing the surgery is experienced. After all, the one who controls the robot is a surgeon. For a successful and smoother operation, it is necessary to have an operation with a doctor who is specialized in robotic surgery.