Laparoscopic & Robotic Surgery

Urologic Laparoscopy

What is it?

Laparoscopy is a technique for operating inside your abdomen through small incisions. Small incisions help you recover faster after surgery, with less pain. A slender, lighted wand-like tool called a laparoscope is used. It connects to a tiny camera, which sends pictures to a video screen. Other slender tools are used to perform the surgery. Many urinary tract conditions can be treated with laparoscopy. These include conditions of the kidneys, adrenal glands, bladder, testicles, and prostate.

How is it performed?

During the procedure an IV line gives you fluids and medications while a tube (catheter) drains your bladder. The laparoscope and surgical instruments are placed through three to five small incisions that are made in your abdomen. Your surgeon sees and operates by watching pictures from the laparoscope on a video screen.

What advantages does Laparoscopy offer?

Laparoscopy, which has been shown to be as effective as conventional procedures, offers many advantages:

  • Shorter hospital stay
  • Less post-operative pain and pain medication
  • Less blood loss and transfusions
  • Less scarring
  • Fewer postoperative complications than open surgery including fewer post operative infections
  • Faster recovery of our patients. For instance, 97% of laparoscopic prostatectomy patients go home the morning after surgery. By comparison, time in the hospital for patients treated with open radical prostatectomy is two to four days
  • Quicker return to normal daily activities
  • Most patients return to work two to four weeks after the procedure and resume exercising or golf in 3-4 weeks. Recovery time for patients treated with radical open prostatectomy is six to eight weeks.
  • The catheter that drains the bladder is removed after seven days in robotic laparoscopic prostate surgeries. In open radical prostatectomies, the catheter is removed after two to three weeks
  • Covered by almost all insurance
  • Costs the same as traditional open surgery


Robotic Prostatectomy

The first daVinci robotic prostatectomy performed in Tulsa was at St. John Medical Center in 2005.  Since then, USO surgeons have performed over 1300 robotic surgeries.  USO continues to be on the "cutting edge" of minimally invasive surgery; our surgeons performed the first robotic partial nephrectomy (removal of a cancerous tumor from the kidney) in 2009 and the first robotic cystectomy (removal of the bladder) in 2010.  USO physicians typically perform 10-14 robotic surgeries each week.

Robotic surgery is performed using the daVinci Surgical System, an advanced system that facilitates surgical procedures through tiny incisions and laparoscopic ports.  The surgeon controls the instruments from a console, and movements are filtered and scaled, resulting in enhanced precision, control, and range of motion.  The specialized camera allows the surgeon to view the operation in 3-D, and the telescope enhances vision to 12x magnification, which provides greater visual detail.

What is a Robotic Prostatectomy?

Robotic prostatectomy, or robotic-assisted laparoscopic radical prostatectomy, is the complete surgical removal of the prostate, seminal vesicles, and vas deferens for the treatment of prostate cancer.  Compared with the traditional "open" operation, the procedure is performed through small incisions using the daVinci Surgical System. 

How is a Robotic Prostatectomy performed?

The abdomen is inflated using carbon dioxide gas, which provides the surgeon with "working room".  Five or six small incisions, ¼ to ½ inch in length, are made in the lower abdomen and ports are placed to keep the incisions open to permit passage of laparoscopic instruments.  The robotic arms are attached to the working instruments, and the surgeon sits at the video console to control the movement of the various scissors, graspers, and cautery used to dissect around the prostate gland.  The enhanced vision and precision of the robot improves the ability to identify the delicate nerves and tiny blood vessels surrounding the prostate.

How about recovery?

Typically, the surgery lasts 2-3 hours in the operating room.  Patients awaken in the recovery room, and discomfort is usually mild.  The next morning, patients are ambulating, eating regular food, and are discharged to home with a catheter in their bladder to allow healing.  The catheter is removed in the clinic in one week.  Patients are usually permitted to resume normal work and exercise activities in 2-4 weeks.


What advantages are there to Robotic Prostatectomy?

Compared to the traditional open radical prostatectomy, robotic prostatectomy offers numerous potential benefits:

  • Shorter hospital stay
  • Less post-operative pain
  • Less need for pain medication
  • Less blood loss and transfusion
  • Less scarring
  • Less risk of infection
  • Faster return to normal daily activities