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How is the prostate removed when doing robotic surgery?

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Posted 7/14/2010 6:30 PM (GMT 0)
Heres an interesting question. I had robotic prostatectomy last week. My wife asked me how they get that walnut sized prostate gland out the pencil sized holes? eyes

Post Edited By Moderator (TC-LasVegas) : 7/14/2010 1:02:15 PM (GMT-6)

Posted 7/14/2010 6:36 PM (GMT 0)
Not sure what pencil sized hole you're referring too...but as I recall, it comes out of one the inch long incisions on the left. And since they don't have to worry about damaging it they yank the yeck out of it...
Posted 7/14/2010 6:56 PM (GMT 0)
The prostate is inserted into a small bag while still in the abdominal cavity. Is is removed typically through the naval passage where the laparoscope is inserted, but it can be done at any of the incisions. While the incisions for the scope and robot arms are small, skin is elastic and can be stretched to allow for the specimen to be removed and analyzed. Typically the surgeon, will examine the prostate tumor palpability and compare it to the remaining facia tissue. If suspect the surgeon will continue dissecting the facia tissue specifically on the side where the tumor was palpable.

Complete DaVinci surgeries are available for viewing on YouTube.

Tony
Posted 7/14/2010 6:59 PM (GMT 0)
friends I added a subject to you post...

Tony
Posted 7/14/2010 7:22 PM (GMT 0)
Mine came out (in a bag, I presume) through a hole that was a lot bigger than a pencil. More like a slit half the size of my pinky. Right over my navel, where I developed a hernia later.

I watched BostonMed (great show) the other night and they were taking an appendix out laparoscopically. They put in in a bag and pulled it right out through a small hole. They called the whole thing the "worm", as it came out, as in "don't lose the worm". :)

There are lots of videos on the web of robotic prostatectomies, if you've got the stomach...so to speak.
Posted 7/14/2010 9:14 PM (GMT 0)
What would we do without plastic bags??
Posted 7/15/2010 2:16 AM (GMT 0)
My prostate was about 60g, larger than most, and I have a much longer slit on the lower right side that I believe the surgeon mentioned was used to bring it out. I am betting the cut with the slit (if there is one) is proportional to the size so as to manage to get it out effectively.
Posted 7/15/2010 2:37 AM (GMT 0)
My Dr said he took it out through the camera port (above the navel, largest cut).
Posted 7/15/2010 2:55 AM (GMT 0)
I wish I could just sh!t it out....I mean, it's just a quarter inch away....!

I don't know who to blame for this, God or Darwin...
Posted 7/15/2010 3:07 AM (GMT 0)
Friends, you ask how they get it out. I don't know for sure, but I hope verrrrrrry carefully.

Sheldon AKA Sleepless
Posted 7/15/2010 3:32 AM (GMT 0)
Apparently the Canadian health-care system is not as bad as our politicians have led us to believe..:)
Posted 7/15/2010 5:02 AM (GMT 0)
Fairwind --- you made me smile. Just as I did when the hospital sent me a bill for $25 for one night in a semi-private room, which was the total cost for hospital, doctors, drugs, a package of goodies to take home --- you name it. Ahhhhh!

Love those smiles!

Keep us posted on your upcoming dance with da Vinci. Or, whatever it is you decide to do.

Sheldon AKA Sleepless
Posted 7/15/2010 11:11 AM (GMT 0)
During robotic surgery, 5 incisions are made with the largest being right above the navel. The prostate is pulled through that incision in a little plastic bag with a string on it. This was explained to us by our surgeon. When my husband asked how something the size of a walnut can be pulled out of a hole that small, the surgeon looked at us and with a straight face said "come on, John, think childbirth."
Posted 7/15/2010 1:12 PM (GMT 0)
At 106 grams mine came out much like the others or plastic bag and the incision typically used from what I've read is at the navel or the largest of the five access points. Not sure why a plastic bag is used as from what I've read prostate cancer, unlike others does not transfer as other types can. Not to worry as plastic is produced from petroleum which is a no no with the Obama administration and will eventually be banned which will require the surgeon to use a "brown bag"! devil

74 - Henry Ford Vatikutti DiVinci 2/10/10 - 106 grams - 3+4 =7 - Three month PSA .o6 - Five month PSA undetectable - zero pads after Two months - sneeze / lifting leaks yes. ED back to where we were with 50 MG Viagra for party time....some leaking at party time is a major turnoff. No regrets! I owe Dr. Peabody a ton!
Posted 7/16/2010 2:24 AM (GMT 0)
I had a prostatectomy eight years ago.

The doctor made a cut between the anus and the testicles.

When I had the stitches (Staples) removed, I asked the nurse how many.

She said there was fourteen.  Nothing was ever mentioned to me about

doing it any other way.   On this board is the first time I have ever

heard of any other way.

Maybe this is why I am having such a bad time with ED. None of the chemicals

work, that's why I am now trying a pump.

Posted 7/16/2010 2:54 AM (GMT 0)
Hi Kolin,
You had the open Perineal procedure. This procedure has been abandoned for the most part. It is still done only in cases where the patient had previous procedure such as a hernia operation. The typical procedure that is done with open cuts is retropubic which is a cut from navel to the pubic area, or by Laparoscope which is a series of holes for the instruments.. In the case this poster is was a robotic thus his question is if they make small incisions, how do you get the prostate out? In most cases it is by using a bag to contain the tissue, and then pulling it out the navel incision.

In open procedures, retropubic is done to provide better access to nerves in a nerve sparing procedure. This in hopes of preventing issues like the one you are experiencing with ED.

Tony
Posted 7/16/2010 3:29 AM (GMT 0)
Thanks Tony for the reply, I knew none of this.

Now......do you have any tips for the ED?

Kolin6

Posted 7/16/2010 4:44 AM (GMT 0)
Kolin, many of us here have used penile injections (caverject, bimix, or trimix) to very successfully get erections similar to before the surgery. You can get your urologist to prescribe them.
Jeff
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