Hypothermic Robot-Assisted Radical Prostatectomy

Radical prostatectomy is surgery to remove all of the prostate gland and some of the tissue around it. It is most often done when the cancer has not spread beyond the prostate gland, and is often successful in removing all cancer cells. However, there may be side effects from the surgery, including incontinence and loss of sexual function. 

A surgeon at miVIP Surgery Center now offersa Clinical Trial for an exciting concept and technique, called Hypothermic Robot-assisted Radical Prostatectomy (RARP), designed to reduce incontinence and improve sexual function. 

About prostate cancer

Prostate cancer is a disease in which malignant (cancer) cells form in the tissues of the prostate, the gland in the male reproductive system located just below the bladder and in front of the rectum. It is about the size of a walnut and surrounds the urethra (the tube that empties urine from the bladder). The prostate gland produces fluid that is one of the components of semen.

Prostate cancer is the most common (non-skin) cancer in men. The American Cancer Society estimates that about 220,800 new cases of prostate cancer will be diagnosed in 2015, and about 27,540 men will die from the disease. About 1 man in 7 will be diagnosed with prostate cancer during his lifetime.

What is radical prostatectomy?

There are four main types or techniques of radical prostatectomy surgery, though today most are done using the da Vinci Surgical System. The surgeon manipulates long, thin tools, including one with a video camera, using robotic arms while sitting at a control console near the operating table.

You will have general anesthesia so that you are asleep and pain free. The surgeon removes the prostate gland and the seminal vesicles, two small fluid-filled sacs next to your prostate.The surgeon reattaches the urethra to a part of the bladder called the bladder neck. A catheter is placedin your bladder to drain urine for approximately 6-7 days.

How is Hypothermic RARP different?

The prostate is surrounded by a complex system of nerves and blood vessels that help control continence and sexual function. Surgeons cause as little damage as possible to these tissues. However, even in ideal conditions, most men take months to 2 years to recover and some never recover fully. Research suggests that the normal trauma caused by the surgery is part of the reason for this.

Dr. Thomas Ahlering, Board Certified Urologist, is the surgeon who developed this technique. He is currently practicing it at the Tustin miVIP facility. He had the idea that hypothermia (cooling the surgical site) might reduce the trauma and improve recovery. The idea is similar to icing strained or sprained muscles after an injury. Cooling slows metabolism and reduces inflammation, which is believed to reduce the extent of the injury. Cardiac surgeons and neurosurgeons often use cooling techniques for the same reason.

How it works

After you are put under anesthetic, the surgeon places a specially designed balloon in the rectum. The balloon cools the important tissues at the surgical site to about 50 degrees F before and during the surgery. After surgery and before the patient is awake, the balloon is removed. The cooling process is simple and pain-free.

Researchers in this Clinical Trial have found that 97% of men undergoing HypothermicRARP returned to pad-free continence. The data also suggests men recover to not needing pads much faster and also experience some improvement in sexual potency.

Surgeons prefer the da Vinci robot

The da Vinci Surgical System features a magnified 3D high-definition vision system and special wristed instruments that bend and rotate far greater than the human wrist. This enables your doctor to operate with enhanced vision, precision, dexterity and control.

Research has proven that da Vinci prostatectomy offers many potential benefits when compared to traditional open surgery, including:

• More precise removal of cancerous tissue.
• Faster return of erectile (sexual) function.
• Better chance for return of urinary continence.
• Less pain and blood loss.
• Lower risk of complications.
• Fewer days with catheter.