DaVinci Robotic Surgery Experience

For those of you who are considering the DaVinci surgery for your prostatectomy, I thought I'd share my story to give you a sense of what it entails. There are others on this forum as well. Treatment isn't an easy decision so every bit of insight can help....right? Kind of long....sorry about that. But hopefully will help provide some ease to those considering or facing this surgery. That's my main intent on sharing it.

When I was first diagnosed, My URO suggested I meet with both the oncologist and surgeon to get their points of view....which I did. As all of us who are forced into the treatment decision know, there are advantages and disadvantages to each treatment option. While the radiation treatment option seemed the less scary path (if that is even a fair evaluation), I decided on the DaVinci robotic surgery. My father died of PC about 22 years ago and I know that he suffered (I believe the horse was out of the barn when he was diagnosed) in his final months. So for me, I knew I wanted the prostate out of me. I didn't want to be worrying if that nasty disease was somewhere inside me cooking on the slow burner. In addition, I could get the pathology and know exactly what I was dealing with. And I accepted the side effects I would potentially have to deal with. OK, the decision was made as to Tx....so one huge hurdle down.

Given my Bx showed low grade (3+3=6 and 3 of 12 cores at 5%), the surgeon wanted me to lose some weight to make it easier on both him and me (was about 240 lbs at that time). So over the course of a year I lost about 25 pounds to get in fighting shape. RALP was scheduled for 5/18/15 at Florida Hospital in Orlando.

I was fairly nervous in the months leading up to the surgery as could be expected but the anxiety level lessened for me a couple weeks before the big day. As a man of faith, I placed my trust in the Lord and asked him to lift that anxiety from me....and I believe that helped. And I had some prayer warriors behind me in family and friends as well. And I thank them for that. Had a few interesting moments when letting friends and co-workers know about the cancer and my upcoming treatment. Watching their faces, I first saw shock and then lots of reassuring sentiments. Guess that's common....human nature being what it is.

The Friday before surgery (5/15/15) I went to pre-register for hospital admittance and give a blood/urine sample. Also answered a number of questions for the nurse and was given two bottles of kick-butt liquid soap to use the night before and day of surgery. Kind of an early check-in to get all the pre-tests and paper work out of the way.

The day prior to surgery (5/17/15) I had to swig a bottle of sodium magnesium for the "cleansing" which I picked up at our Publix grocery store (I recommend the cherry flavor). Nothing to eat that Sunday but could drink liquids/broth. Also paid a bunch of bills, got a haircut, hit the gym for a final workout and completed a few house chores so I wouldn't have to deal with those things for a while.

Arrived at the hospital at 10:20AM on 5/18/15...and then waited for about 45 minutes before they called me back to the pre-op area. Nerves were at a fairly low level thank God since I had crossed that mental hurdle of making the final decision. Watched a few patients get wheeled by on the beds and thought how that would be me in a few hours.

Changed into the patient gown (and I use the term loosely here) and socks (bright yellow); quite the fashion statement if I say so myself. I was in a curtained off cube so had to be sure the legs were closed when that curtain was open....if you know what I mean. An older lady was in the cube across from me....no sense in sending her off for her surgery with images of my privates dancing in her head. Had blood pressure taken
and answered more questions and asked a few myself. IV line also inserted (I have deep veins so took 2 attempts but wasn't too bad). Friendly, re-assuring nurses. The the anesthesiologist came in and asked more questions and explained the procedure and experiences I may have with the anesthesia (wish he would have emphasized the post-op bloating I would experience a bit more from the gas they pump into aid surgery). Then the surgeon came to see how I was doing. I like him and trust him; very confident, friendly and re-assuring. Once he was done, I got a dose of Versed which helped relax the nerves. Too bad you can't buy that over the counter....

Moved me into the operating room about 1:50PM as I recall. An array of ceiling lights in my line of sight as the mobile bed was moved down one hall and then another on the way to the operating room. Operating room seemed fairly large and spacious to me. I could see the DaVinci machine about 10 feet away...all white with multiple "arms" covered in plastic. Now that's an amazing machine for you. A nurse introduced hereself but had here surgical mask on so I couldn't see much of her face. I remember looking at the operating table then looking back to the DaVinci......and then...I woke up in recovery. Wonders of modern medicine for you!

Surgery took about 2 hours and I was in post-op recovery for about an hour (or so I'm told). First image on waking up was male nurse sitting next to my bed who kindly gave me some ice chips. Didn't see many other patients in this area....guess my afternoon surgery put me on the late shift. Was moved to a private room a short time later (12th floor with great view to the east) where family joined me. Guess that was about 5:30PM or so. I viewed more ceiling lights on that journey along with folks pretending not to notice me on the hallways and elevator. I remember wondering if it would hurt when the bed bumped across the elevator thresh hold (it did not). For me, there wasn't a lot of significant pain but more of lower level soreness and some discomfort. Still had the IV of course and my new friend the catheter (known from here forward as Bagger Vance). Thank goodness that was inserted during surgery so I had no memory of that procedure. BTW - prior to surgery I was wondering how much they would shave....and if they would shave "down there". In my case, only a large rectangle was shaved on my belly...from about 3 inches above the belly button to 3 or 4 inches below....and about 7 inches to either side of the belly button. Nothing shaved "down there". Once in the room, the nurse hooked some sort of wrap on the lower portion of each leg which squeezed every 10 seconds or so....apparently to minimize risk of clots. It felt kind of good for the first few hours but I got tired of it by the middle of the night. Plus it was connected to tubes (to force the squeezing I assume) which I sort of got tangled in during the night as I rolled over in the bed. Didn't really get a lot good sleep...probably in 30 minute doses or so. IV pump was right near my head where I could hear that darn thing all night. Floor nurses were great and checked on me periodically. Was given Percoset which took the edge off. Family stayed for a little while....and wife much longer. Had the TV on but my overnight bag didn't make it to my room so didn't have my glasses. Not to worry, the bag was found safe in the pre-op area in a locker. It made it to my room the next morning about 10 minutes before I was discharged. Guess Delta airlines trained their "transportation" department. During the early morning hours I experienced a little indigestion. Wasn't too bad but I asked the nurse for a Tums or Rolaids but they couldn't give it to me because it wasn't on the doctor's order. Morphine I could have....but Rolaids was forbidden. But I digress....

I had five incisions; 2 above the belly button, 2 to one side and below and 1 to the other side and below. Also had a JP closed suction drain inserted on the left side of my belly into which a reddish watery substance would be collected. That didn't bother me at all. But again, not a great deal of pain which was surprising.

So the hours ticked by that night with Bagger Vance at my side and mechanical sounds whirring in my head. Saw a few medical helicopters landing during the night as the landing pad could be seen from my window. Also got a nice view of the rising sun the next morning.

I took my first walk about 8AM the next morning down the hallway using just the IV tower as an assist. Felt pretty good considering all I had been through but was moving slow. The surgeon came in about 9AM to see how I was doing and re-assure me that everything went well. Said I would be discharged in a few hours and to see him next week for CT scan & catheter removal. Said my prostate was fairly big (49 g) and that I would urinate much better as it had been partially blocking the urethra....and today I will tell you he was right! Also said I could start showering again the next day (2 days after surgery)

A nurse took the JP drain out later that morning. No pain but just an odd sensation for a couple of seconds. That incision has healed up nicely since then. Was discharged about 12PM...making it about a 14 hour stay overall in the hospital.

Was uncomfortable on the 20-minute ride home; still being sore and fatigued it was hard to get in / out of the care (don't worry....wife was driving). Once home I laid on the couch and did some walking (in the house) for the rest of the day. Oh yeah....and emptied Bagger Vance when needed.

For the next three days, the main issues for me were 1) the bloating / belly pressure from the gas they used to inflate my belly for surgery and 2) getting used to the catheter. Guess I was hoping the gas would "pass" rather quickly but this stuff took it's own sweet time to work it's way through my plumbing. Took about 3 or 4 days for all of to work it's way out one orifice or the other so to speak. Much relief once that was gone. Didn't eat much the first 2 days home (mostly yogurt, applesauce and toast) but drank lots of water (which resulted in getting to know Bagger Vance on a personal level). I was also easily fatigued and would nap during the day (with a Percoset chaser).

For me, the catheter wasn't painful but was more of an irritation...plus a little bit of a head game knowing it was in me. I got pretty good at moving around with it and learned fairly quickly how to hang it on this knob or that hook for short periods of time around the house while I did some task or another. The catheter was held in place by some firm type of taping on my left thigh. However, after a couple of showers, that tape lost much of its adhesive properties so I had to apply paper tape each day over the tape I came home with on the thigh to hold the tube in place. Also found out that I needed to allow a length in the tube from where it was taped to my thigh to the entrance of my manhood to give it a little play for when I rolled over in bed each night. Not much...maybe a centimeter or two. Per doctor's advice, I applied Neosporin to the manhood each day but stayed away from lubricant's like Vaseline which he said would dry up and be counterproductive. I see others have used KY with good results...personal choice I guess. Overall, the catheter seemed to slide in/out what little movement I need it to do without much problem. For sleeping, I placed a step ladder next to the bed to which I duct-taped a chip clip (used a magnetic one that was hanging on our refrigerator). Would hang the catheter bag to that clip at night. Key thought here is to improvise!

Got the pathology report 2 days after surgery. My Gleason went from a 3+3=6 to 4+5=9. That was a shock of course but the good news was it had not moved out of the prostate and the margins were clean. My doctor was fairly re-assuring about it leaving me the impression I had just dodged a bullet. I understand the implications for sure and await the PSA tests in the coming weeks / months.

First bowel movement was 4 days after surgery. No problem there and plumbing has been working fine every since. Over the next few days, I took it easy, did some walking, continued drinking lots of water, and tried not to think about the upcoming doctor's visit where the catheter would be removed. The days passed and it was time to go see the doctor again for CT scan / catheter removal. That was on 5/26/15.

CT scan was no big deal. Took all of 15 minutes. One scan prior to injecting the dye....one scan after dye injection (in catheter port) to see if any leaks. Performed by a very re-assuring tech who explained everything and talked me through it. Thank goodness there were no issues. Met with the doctor a few minutes later who re-iterated what he first told me about the pathology and said everything was looking "text book" so far and I could get the catheter removed. Said to come back in 4 weeks and gave me a scrip for PSA test. Up until now, I thought he'd be the one to remove the catheter. Not so. It was his nurse (a pretty blond of course). At this point I'll say what others have said. Us men must check our pride at the door when dealing with this disease. Now I will confess that I had a low level of anxiety wondering how the "extraction" would feel. Just seemed to me that whatever the experience, it would necessarily include some pain. But not so! The nurse had me sit on this funky semi-reclined throne-type chair and spread 'em. She then inserted a syringe into the port on the catheter to deflate the bulb in my bladder. Didn't feel any sensation with that. She then told me to take a deep breath and then exhale. At the moment I exhaled, she pulled the catheter out. Now I will tell you that it didn't hurt...no pain....but it was another very odd sensation as I felt that tube move through my plumbing out out into the daylight again. I did have a mild burning sensation at the "tip" for 15 seconds or so. But the actual experience honestly wasn't worth the anxiety I had anticipating it. It was over before I knew it. I did notice a few drops of watery red fluid leak out out before I could put on my man diaper for the ride home. So total of 8 days with the catheter for me. I see from other posts that the duration could be longer which I assume is due to particular circumstances.

I'm now 18 days past my surgery. Since the catheter removed I have been using pads...about 3 a day I would say. Not a lot of leakage but a few small squirts a day. Some days less than others. Sometimes when I sit up....other times when I'm still. I have no problem urinating or holding it until I am ready to release. No problems at night either. For the first 3 or 4 days after the catheter was removed, I would pass a few drops of bright red blood immediately after emptying my bladder. A bit disconcerting at first but the doctor & nurse both said it could happen. It was there for about 3 days, stopped for a day, then came back for another day or two. But I haven't passed blood in the last couple of days so hopefully another hurdle has been cleared. I continue to walk a lot and drink lots of water and juice (have added coffee and the occasional soda back into the rotation). My appetite is coming back as well. I hoping for continence in the coming weeks/months and that the hydraulics work as well (haven't tried that out yet so can't report anything in that area).

For me, surgery was the right call. It's out of me and I now know what it was. I believe I'm in good hands and I'll deal with whatever the future may bring. I'll continue to believe I dodged that bullet until someone tells me otherwise. As a final thought, I'll say that the overall experience so far hasn't been equal to the anxiety I had anticipating it. My thoughts and prayers are with all of us club members who face this disease.

Newgrange: That was a great narrative; my DaVinci experience was the week before yours in NYC and was about 99% the same. Everyone has to make their own decison based on so many personal variables, but your description was spot on from my experience. I won't cheerlead this option or criticize another, but concur with your experience. Of minor note: I wasn't wheeled in; i walked in and the anesthesiologist patted the table and said, "Hop on up". Lights out... (I opted for the lemon sodium magnesium for the cleansing vice the cherry. Nasty stuff. Next time I have my prostate removed I will go for the cherry I think.) All the best.

Age 56 (in 2015), Father had PCa (prostatectomy still alive/92); uncle on mother’s side had PCa (never tested spread to kidney died at 79),
PSA 2005–Nov 2011 rose 2.3 to 4.3 along with chronic prostatitis; treated with antibiotics
Biopsy Nov 2011 Negative
PSA Jan 2015: 5.1
Free PSA Jan 2015: 12%
MRI guided Biopsy Feb 2015: 2 of 12 cores positive each core scored G6 right lateral base and right lateral mid; T2a
Second and third biopsy opinions sought (different urologists)/all concurred
CT Scan: negative
PRE-OP MRI: Tumor in Rt. Femur
Bone scan: Benign tumor in femur based on MRI
DaVinci Surgery with Dr. Samadi Lenox Hill NYC: May 2015
Post surgical pathology: G7 (3+4), Margins, LN, SV all negative
Prostate size 38g, Histologic Adenocarcinoma, acinar type
Tumor size 1.0 cm
25% organ involvement
State: T2N0
High grade PIN
7 days cath
Continenence: Some days better than others; steady improvement
ED: You betcha I have ED; 5mg Cialis daily; GNC Arginmax
PSA @ 6 weeks: TBD

Post Edited (DOL1983) : 6/5/2015 10:28:25 AM (GMT-6)

My experience was quite similar. I also got a post surgery pathology upgrade, to G3+4. Keep us posted on your progress. It's good to see positive surgical stories with good outcomes.

My experience was like yours. In surgery at 2:30 pm and checked out of the hospital the next morning around 10 am after I eat a large breakfast. Ride home was a little painful thanks to all of the pot holes in New Orleans streets. It as a none event when the catheter was removed 10 days after surgery. But it was a problem for the 10 days, it was huge and caused constant pain at the end of the penis resulting in a stricture days after it was removed.

Getting home there wasn't much pain, more like soreness after being hit in the abdomen a few times, which Aleve took care of. During the first couple of days the only pain was getting up or down out of a chair or anything that used the abdominal muscles. But the first two nights I had a lot of pain from the CO2 migrating up to the shoulder blades and required me to take a hydrocodone and ambien to sleep.

Recovery was quick, I could have gone back to work after 10 days when the catheter was removed, but I had plenty of sick time so I opted to stay out for 3 weeks.

BTW, I was fully continent and zero ED issues, even experience night time erections while the catheter was still in (not good!).

Good to hear from you Greg down under. Glad it's going well for you. I wound up on the 17th floor after surgery, and I had a view of the door. My roommate had the view (downtown St. Louis, I honestly couldn't say which way we were facing).

Yep, great facility and staff. Actually a little over a 4 hour drive home. Stopped and stayed in a motel half way home.
Footie is Rugby League, a game played in Australia. It is our more ferocious version of gridiron(lol).
Beautiful winters day here. 22degrees Celsius, sun shining, and a long weekend. about to sit down and watch the " footie".
Cheers
Greg

Greg, how's the line go:

Rugby is a game for hooligans played by gentlemen, while football (soccer) is a game for gentlemen played by hooligans?

My daughter went to a women's college that had a rugby team. She made periodic comments about which sports teams sported the most ice packs after practice. Rugby was usually in the lead, followed by the swimmers (shoulders) and rowers (shoulders and knees).

Glad to hear more surgery success stories!

You're just a few weeks since surgery, so yeah, things will be sensitive down there for a while. It didn't happen to me, but I've heard of men who had their scrotum swell to "grapefruit size" following RALP and turn every color of the rainbow.

You might find that wearing a jockstrap will support things and make it more comfortable....but I'm not quite sure how a pad would work with one.

Keep us posted about your progress....(you haven't been massaging down there, have you?)

I had that happen but it was a day or two right after surgery.
You might give your uro a call. In the mean time, throw a bag of frozen peas down there to help reduce the swelling.

Bill from Florida

I didnt have much swelling down there, but my right nut was definitely somewhat more sensitive after the surgery, for about 3-4 weeks. Then one day, it just disappeared. (the sensitivity, not my right nut)

Newgrange,
Even though Gary's PCs was too advanced for RALP, you're post was a fascinating and informative read, with a smattering of humor...nice. Sounds like you made a good decision with the G9 shocker. Join the club, but post the zeros bro!
Beth n Gary

Halbert - funny thing...my Dr didn't mention how soon it would be OK for sex but the use it or lose it philosophy sounds like sage advice to me.

Beth n Gary - thanks for checking in. Hoping for very favorable PSA in two weeks.

Doug - thanks....hope it helps give some insight. Saw your other post and would agree with the consensus that a biopsy would be best; it would surely be my choice. I see you've been down this road before so my prayers are with you as well.