Assoc. Prof. Dr. Mustafa Kirac, a urologist, explained the robotic surgery treatment in prostate cancer.

One of the most important problems of the aging man is prostate enlargement. As men age, their problems with prostate enlargement become important for both the patient and the physician.

The prostate is a 15-20 gram organ located at the outlet of the urinary bladder in men. It produces a hormone that liquefies the sperm and ensures the continuity of the urinary tract. Enlargement of the prostate begins and continues in the 40s. This enlargement is benign or malignant. Benign enlargement is called Benign Prostatic Hyperplasia (BPH) and malignant enlargement is called prostate cancer.
The diagnosis and treatment of benign and malignant enlargement are completely different. Their processes and follow-ups are also different.

However, in both cases, the patient's complaints are similar. Findings such as difficulty urinating, frequent urination and night urination are seen in both enlargements. A patient who is admitted to the hospital with benign enlargement findings should first be carefully evaluated to reveal the type of enlargement. In order to distinguish benign or malignant enlargement, a hormone test called PSA and a digital prostate examination are performed on the patients. In addition, when necessary, evaluation of the prostate with MRI (Magnetic Resonance Imaging) or a prostate biopsy can be performed for this distinction.

Robotic Surgery For Prostate Cancer

In the patient diagnosed with prostate cancer, the disease should be staged first. That is, the degree of prevalence should be determined. If the disease is limited to the prostate, the treatment is surgery. We call the surgery for prostate cancer radical prostatectomy. Surgical treatment can be done by open or laparoscopic method. Open surgery is a standard surgery. Closed surgery, on the other hand, is an operation performed through robotic technique. Robot is a more advanced method that has entered urology practice in the last 20 years.

Robotic surgery is basically a closed surgical technique. The abdominal cavity of the patient is inflated with gas, and the arms of the robot are inserted into the abdominal cavity through holes of approximately 8 mm width, and surgery is performed by taking a three-dimensional and detailed image in the abdomen. The important point here is that the surgeon performs the operation. The robot mimics the surgeon’s movements. In other words, the surgeon's inside hand is the robot's arm. The surgeon does not touch the patient. The assistant next to the patient helps the surgeon.

This method has many advantages. It provides less pain, less scarring and faster return to work. In robotic technique, conditions that disrupt the comfort of life such as erectile dysfunction and urinary incontinence caused by surgery are much less common. Permanent urinary incontinence in robotic surgery is almost zero in surgery performed by an experienced robotic surgeon. Similarly, erectile dysfunction is much less common than in open surgery. These surgeries can be performed by specialist physicians who have received robotic surgery training and are certified in Turkey.