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ROBOT-ASSOCIATED RADICAL NERVESERVATING PROSTATEKTOMY

Radical prostatectomy is the main treatment for prostate cancer. Surgery is performed on those men who have a localized form of prostate cancer, i.e. the tumor does not go beyond the boundaries of the affected organ.
Radical prostatectomy is considered to be one of the most complex surgical interventions in urology, because the surgeon's task is not only to rid the patient of the tumor, but also to ensure a high quality of life - the normal function of urination and erection in the postoperative period. For this, it is important not only to remove the prostate gland itself, but also to preserve the thin structures surrounding it - the neurovascular bundles. Such an intervention is called radical nerve-saving prostatectomy.
During the operation, the prostate gland and seminal vesicles are removed, and an anastomosis is formed between the bladder and urethra. If there is evidence, removal of the surrounding lymph nodes is performed. After surgery, the bladder is drained by a Foley urethral catheter, which is usually removed 5-7 days after surgery. Patients in the postoperative period are also offered a program of early rehabilitation of urination and erectile function.
The most modern and gentle method of operation is a radical nerve-saving prostatectomy on the da Vinci robot. Thanks to the use of the da Vinci robot, it is possible to achieve the highest precision of the movements of the instruments so that, at a 10-fold increase, they are isolated from the surrounding tissues and preserve the structures responsible for urine retention and erectile function. High results of treatment are also provided thanks to an improved method of performing the operation.
We propose such an operation for our patients to be carried out in St. Petersburg. The results of operations today are comparable with those of leading European clinics.
The estimated cost of the operation is 350,000 rubles.

When performing a radical prostatectomy, all the advantages of the da Vinci robot are revealed:
Exact and confident work in a limited volume of the pelvic space

- Minimal blood loss
- Removal of the prostate gland with preservation of adjacent neurovascular bundles
- The imposition of a reliable anastomosis between the bladder and urethra
- Low level of pain in the postoperative period
- Good cosmetic effect - barely noticeable marks on the skin in the places where trocars and robotic manipulators are installed

For a consultation about the possibility of performing a radical, nerve-saving prostatectomy, patients should be thoroughly examined, including:
- multifocal prostate biopsy with established histological diagnosis of prostate adenocarcinoma and - determination of the total score on the Gleason scale;
- blood prostate-specific antigen (PSA) levels;
- MRI of the pelvic organs with intravenous contrast (images and conclusion);
osteoscintigraphy (scintigraphy of the bones of the skeleton).



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