Laparoscopic (Key-Hole) Nerve Sparing Prostatectomy
For men suffering from localised prostate cancer one of the treatment options is to remove the whole of the prostate and its surrounding structures. This is called a radical prostatectomy.
"Currently, radical prostatectomy is the only treatment for localised CaP that has shown a cancer specific survival benefit when compared to conservative management in a prospective, randomised trial."
- European Association of Urology guidelines on Prostate Cancer 2008
The newer minimally invasive techniques allow this to be performed using laparoscopic (key-hole) techniques.
The surgeons in Manchester Urology were among the first in the northwest of England to offer this laparoscopic (key-hole) prostatectomy and we have the largest series of patients in the region. The operation is carried out through small entry ports that are placed in the lower half of the abdomen after a space is made in front of the bladder. The magnification provided by the telescope gives a greater accuracy in the dissection of the prostate. This means that the nerves that provide erections can be preserved lowering the risks of impotence. Smaller wounds also means an earlier return to full activity and a lower chance of operative complications.
For most patients the stay in hospital will be between 2 -4 days with a catheter in place for 7-14 days following the procedure. Urinary incontinence will be a problem for around 5% of patients in the long term and the quality of post-operative erections will vary depending on the ability prior to the operation and whether the stage of the cancer allows a full nerve sparing approach.