Advantages of Da Vinci Robotic Surgery for Prostate Cancer

Prostate cancer surgery is one of the most effective and definitive methods for treating the disease in its localized stage. Thanks to revolutionary advancements in healthcare technology, Da Vinci prostate surgery has elevated this challenging process to a much safer level for both patients and surgeons. By allowing surgeons to work through millimetric incisions, this high-tech system minimizes the risk of bleeding and greatly aids in preserving the delicate nerves responsible for urinary control and sexual function. Compared to traditional open surgery, your hospital stay is shorter, meaning you can return to your daily life and loved ones much faster—whether that means enjoying a walk along the Bosphorus or simply relaxing at your hotel in Istanbul.

• The Da Vinci system scales down the surgeon's hand movements, transmitting them to the tissues with flawless precision and eliminating the risk of natural hand tremors.
• The surgery is performed through a few small keyhole incisions (8 to 12 millimeters) in the abdomen.
• The risk of postoperative pain, infection, and bleeding is significantly lower compared to open surgeries.
• The likelihood of unwanted side effects, such as urinary incontinence and erectile dysfunction, is noticeably reduced.
• The hospital stay typically spans a brief period of just 1 to 3 days.

What is Da Vinci Robotic Prostate Surgery?

The Da Vinci robotic surgery system is a high-tech, minimally invasive surgical method where the surgeon manages the operation from a console. The word "robot" in its name can sometimes cause confusion; however, the surgery is entirely performed by your expert surgeon, not an autonomous, decision-making machine. The system consists of a control console where the surgeon sits, a patient-side cart holding the robotic arms, and a camera system providing a high-definition 3D view.

In male anatomy, the prostate gland is located deep within the pelvis in quite a narrow and confined space. The camera of the Da Vinci system magnifies this area 10 to 15 times, offering the surgeon a three-dimensional, exceptionally clear view. The miniature surgical instruments at the tips of the robotic arms can bend and rotate at a much wider angle (540 degrees) than the human wrist ever could. This makes it possible to precisely remove the cancerous tissue without damaging the vital nerves and blood vessels surrounding the prostate.

Who is it For and Why is it Preferred?

Robotic surgery is generally performed on patients whose cancer is confined within the prostate gland (localized) or is just beginning to spread slightly outside of it. Early diagnosis directly increases the success rate of the surgical intervention and the patient's quality of life. You can find detailed information on this topic in our article titled Prostate Cancer Symptoms and the Importance of the PSA Test.

When making a decision for surgery, we consider not only the patient's age but also their overall health, heart and lung functions, and the aggressiveness of the cancer (Gleason score). The Da Vinci system is often the first choice, especially for patients who need the crucial nerves around the prostate—responsible for sexual function and urinary control—to be preserved. For international patients looking to avoid the large incision scars, long recovery periods, and high bleeding risks associated with open surgery, robotic surgery is an ideal option.

Preoperative Preparation and Diagnosis Process

The foundation of a successful surgery lies in a meticulous preparation process. During the diagnostic stage, advanced imaging and tissue sampling techniques—such as blood tests (PSA), multiparametric prostate MRI, and MRI fusion biopsy—are used to precisely determine the location and extent of the cancer. Once the decision for surgery is made, a detailed blood count, kidney and liver function tests, an ECG (electrocardiogram), and a chest X-ray are performed to evaluate the patient's suitability for anesthesia.

About a week before the surgery, blood-thinning medications may need to be stopped or adjusted, always with the approval of a cardiology specialist. On the day before the surgery, you should eat light meals and fast (no food or drink) for at least 8 hours starting from midnight. Since the prostate gland is located very close to the lower part of the large intestine (rectum), an enema may be administered on the morning of the surgery to cleanse the bowels.

How is Prostate Cancer Surgery Performed with Da Vinci?

The operation is performed under general anesthesia, meaning you will be completely asleep and feel no pain. To create a comfortable workspace inside the abdomen, it is gently inflated with carbon dioxide gas. Then, 4 or 5 small incisions, about 8 to 12 millimeters in diameter, are made in the abdominal wall. Thin tubes called "trocars" are placed through these incisions, and the robotic arms along with a high-definition camera are advanced into the abdominal cavity.

The surgeon sits at the console and carefully separates the prostate gland from the bladder and the urinary tract (urethra). At this stage, the nerve bundles responsible for erections are peeled away from the prostate with microscopic precision and preserved. The removed prostate gland and surrounding lymph nodes are placed in a special retrieval bag and extracted from the body. In the final step, the bladder and the urethra are sutured together leak-proof using robotic stitches (anastomosis), and a urinary catheter is placed to support the healing process.

Advantages of Robotic Surgery Over Open Surgery

In traditional open prostate surgeries, a large incision extending from below the belly button down to the pubic bone is required. Because robotic prostate surgery is performed through just a few small keyholes, it yields much better cosmetic results, and the risk of a postoperative incisional hernia is almost non-existent. Furthermore, the absence of a large incision ensures that the patient experiences significantly less pain after the operation.

In open surgery, reaching the depths of the pelvic region and securing a clear view is quite challenging. Thanks to the three-dimensional, magnified view and tremor-free robotic arms provided by the Da Vinci system, tissues can be distinguished much more clearly. The pressure created by the gas introduced into the abdomen suppresses bleeding in small capillary vessels. As a result, blood loss is minimized, and the need for a blood transfusion during or after the surgery rarely arises.

Recovery Process After Prostate Surgery

The recovery process after prostate surgery is one of the most common concerns for patients. When you wake up from surgery, you will have a catheter in your urinary tract and a thin surgical drain to remove fluids accumulating in the abdominal area. The drain is usually removed the day after the surgery. Patients are assisted by a nurse to take short walks on the evening of the surgery or the following morning; mobilizing early speeds up bowel function and reduces the risk of blood clots.

After you are discharged from the hospital, the urinary catheter will remain in place for about 7 to 14 days. While the catheter is in, you can easily walk around your accommodation and take care of your basic daily needs. Once the catheter is removed, we recommend starting pelvic floor (Kegel) exercises to strengthen your urinary control muscles. During the recovery period, it is crucial to drink plenty of water, consume fiber-rich foods to prevent constipation, and avoid heavy lifting, cycling, or strenuous sports for the first 4 to 6 weeks.

Possible Complications and Risk Groups

As with any major surgical intervention, robotic prostate surgery carries certain risks. In addition to risks associated with general anesthesia, infection or bleeding may occur, though rarely. The two most prominent side effects specific to prostate cancer surgery are urinary incontinence and erectile dysfunction. While robotic surgery minimizes these risks, it does not eliminate them entirely.

Urinary incontinence is usually temporary, and the vast majority of patients regain full urinary control within a few weeks to a few months. The permanence of erectile dysfunction depends on the patient's preoperative sexual function, age, and how well the nerves could be preserved given the location of the cancer. Even if the nerve-sparing technique is successfully applied, it can take anywhere from 6 to 24 months for sexual function to return entirely to normal.

When to See a Doctor

During your recovery process at your home or hotel, certain symptoms may require immediate medical intervention. You should contact your doctor without delay if you experience any of the following:

• A body temperature rising above 38°C (100.4°F) accompanied by chills or shivering.
• A complete stop in urine flow from the catheter, along with severe bloating and pain in the lower abdomen.
• Heavy, dark red bleeding with large clots in the urine collection bag (a light pink color is considered normal).
• Increasing redness, swelling, warmth, or a foul-smelling discharge at the surgical incision sites.
• Sudden swelling, redness, and pain in one of your legs, particularly in the calf area (suspicion of deep vein thrombosis).

If you experience sudden, severe chest pain, shortness of breath, palpitations, or a feeling of fainting, you should call 112 (the emergency hotline in Türkiye) or your local emergency number immediately.

The Robotic Surgery Process at BHT CLINIC

At the BHT CLINIC İstanbul Tema Hastanesi Urology clinic, we perform the diagnosis and treatment of prostate cancer at international standards using a multidisciplinary approach. For our patients who receive a definitive diagnosis via MRI fusion biopsy, we create personalized treatment plans using the advanced Da Vinci robotic surgery system. Our experienced urology specialists, alongside our oncology and pathology teams, meticulously monitor the entire process before, during, and after surgery. Our hospital's 24/7 emergency department and fully equipped intensive care units ensure you feel safe at every moment of your recovery. For any health-related questions and to schedule a consultation, you can visit our appointment page.

Frequently Asked Questions

How long does robotic prostate surgery take?

Although the duration of the surgery varies depending on the size of the prostate, the extent of the cancer, and the patient's anatomical structure, it is generally completed within 2 to 4 hours. Preparation for anesthesia and waking up times are in addition to this.

Is urinary incontinence permanent after surgery?

Because the sphincter muscles responsible for holding urine are preserved much better in robotic surgery, urinary incontinence is usually temporary. The vast majority of patients regain full urinary control within the first few months, aided by pelvic floor exercises recommended by their doctor.

Does a robot perform the robotic surgery?

No, a robot does not perform the surgery on its own at any stage. The Da Vinci system is an advanced medical device operated under the control of an expert surgeon, translating the surgeon's hand movements into the patient's body with millimetric precision.

When does sex life return to normal after surgery?

The return of sexual function depends on the patient's age, preoperative performance, and whether a nerve-sparing technique could be applied. The recovery process varies from person to person, and it can take anywhere from 6 months to 2 years for functions to be fully restored.

When is the catheter removed after surgery?

The catheter is usually kept in place for 7 to 14 days to ensure that the new connection (anastomosis) between the bladder and the urinary tract heals safely. The removal of the catheter is a painless and brief procedure performed in an outpatient clinic setting.

This article is for informational purposes only; please be sure to consult your physician for diagnosis and treatment.