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Laparoscopic Radical Prostatectomy

Laparoscopic Radical Prostatectomy

Laparoscopic Radical Prostatectomy

Package Cost : $7,000

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Minimally invasive surgery for localized prostate cancer that involves few, small key hole incisions through which specialized instruments are inserted and the entire prostate gland is removed along with seminal vesicles and some neighbouring lymph nodes. 

 

By virtue of PSA screening, Prostate Cancer is being detected early when the cancer is still limited to the prostate gland and the patient does not show any symptoms as yet.  Large number of men are being diagnosed every year with prostate cancer, globally. Radical Prostatectomy is a viable treatment option for men with organ confined prostate cancer.

 

Radical Prostatectomy or removal of cancerous prostate gland alongwith some neighbouring tissues, may be carried out through either of the two surgical approaches, namely 

 

Open Radical Prostatectomy, the conventional surgical approach which involves a large single 8 to 10 inches longitudinal incision below the umbilicus (belly button) to access the surgical site and remove the prostate gland. Sometimes, the surgical site is accessed through an incision made in the perinium(an area that lies between scrotum and anus).

 

Minimally Invasive Prostatectomy, the most advanced surgical approach that has an edge over the conventional Open Radical Prostatectomy. It is further subdivided into two main types,

  • Laparoscopic Radical Prostatectomy: Several small key hole incisions(each less than half an inch) are made on the abdomen to pass the specialized surgical instruments and a video camera through them and remove the prostate gland through one of the incisions. It provides the surgeon, a magnified view of the surgical site. 

  • Robotic or Robot Assisted Laparoscopic Radical Prostatectomy: Like in Laparoscopic Radical Prostatectomy, in this surgical approach as well several small key hole incisions are made across the abdomen, however, in Robot Assisted technique, the surgeon performs the operation with the help of a Robotic system over which he has full control. He sits on the console and Robotic arms which he controls, carry out the surgery with remarkable precision.
     

 

 

 

 

Q1. What are the advantages of LRP(Laparoscopic Radical Prostatectomy)?

 

A1. The advantages of Laparoscopic Radical Prostatectomy over Open Radical Prostatectomy are:

 

  • Shorter hospital stay
  • Low cost of care
  • Minimal blood loss
  • Less requirement of pain medications
  • Aesthetically good results
  • Early removal of catheter
  • Early resumption to normal activities

​Q2. When is Laparoscopic Radical Prostatectomy considered?

 

A2. Laparoscopic Radical Prostatectomy (LRP) surgery is considered as a viable treatment option in case of a localized prostate cancer (strictly confined to the prostate gland) and no evidence of its spread beyond the gland to the neighbouring tissue or distant metastasis. The most eligible candidate for Radical Prostatectomy is a person who has prostate cancer limited to the organ itself, is younger than 75 years and expect to live at least 10 more years.

 

Q3. What are other treatment options besides LRP, for Prostate cancer?

 

A3. There are several treatment options besides Laparoscopic Radical Prostatectomy for Prostate cancer patients. They are:

  • Active Surveillance (Watchful waiting)
  • HIFU(High Intensity Focused Ultrasound)
  • Open Radical Prostectomy
  • Robotic Assisted Laparoscopic Radical Prostatectomy
  • Brachytherapy(Low Dose or High Dose Brachytherapy)
  • EBRT(External Beam Radiotherapy)
  • Hormonal Therapy
  • Cryotherapy
  • Chemotherapy

 

The best treatment protocol required in your case, whether alone or in combination, can only be decided by your treating doctor after your clinical examination and evaluation of your reports.

 

Q4 How much time does the Laparoscopic Radical Prostatectomy surgery take?

 

A4  Laparoscopic Radical Prostatectomy surgery usually takes around 3 hours. However, it may vary from patient to patient.

 

 

Q5 How soon does the patient recover from Laparoscopic Radical Prostatectomy surgery?

 

A5 The patient recovers quickly post Laparoscopic Radical Prostatectomy Surgery as compared to the recovery period post conventional radical prostatectomy surgery. The Foley's catheter is removed around third day after surgery, or at the most 7 days after the surgery whereas in Open Radical Prostatectomy surgery Foley's catheter may have to be kept inserted for around 2 or 3 weeks after surgery. 

Patient feels significant improvement and lesser need for pain medications.

 

Q6 What is done before Laparoscopic Radical Prostatectomy?

 

A6 Your surgeon will guide you through the whole process. You will be prepared for the surgery. Modification of diet, preparation of bowels, scheduling the medicines regimen and infact, you will be told to stop taking any blood thinning medicines such as Aspirin, at least from a week before the scheduled surgery, if you might be taking. Follow your surgeon's advice religiously.

 

Q7 What does Laparoscopic Radical prostatectomy involve?

 

A7 LRP is carried out while the patient is put on General Anesthesia. In layman's terms, patient is put to sleep while the surgery is carried out. Small incisions are made for surgical instruments and video camera to pass through them and access the prostate gland. prostate gland along with seminal vesicles are removed. If need be, lymph glands are also removed for biopsy and checked for the presence of cancer in them. Finally, the urethra is reattached with the bladder.

 

Q8 What is done after the Laparoscopic Radical prostatectomy surgery?

 

A8 Once the surgery is over, your diet will be slowly and gradually resumed to normal from nil per oral, to clear fluids to semi solid food to finally normal diet. The exact time will be determined by your surgeon after clinically evaluating the return of your bowel sounds. You will be encouraged to get up and walk as soon as possible to promote blood circulation thereby preventing complications and aid in quick recovery. Hospital stay is around 2 to 3 days and all this while your recovery process and presence of any complications will be thoroughly evaluated and appropriate advise shall be given by your surgeon for the way ahead.

 

Q9 How long is the hospital stay in case of Laparoscopic Radical Prostatectomy?

 

A9 Hospital stay can be as short as one day post surgery or may be 2 to 3 days at the most. It varies from patient to patient. However, most of them are discharged in 1 day after the surgery.

 

Q10 How much is the blood loss during the Laparoscopic Prostatectomy surgery?

 

A10 You will be glad to know that there is minimal blood loss during Laparoscopic Prostatectomy. It is as low as 150cc. Blood transfusion is rarely required.

 

Q11 What does Prostate Cancer Screening mean?

 

A11. Cancer screening, in general, means that certain tests are done to look for cancer even before they cause any symptoms. Prostate cancer screening involves carrying out investigations pertaining to prostate cancer that help find the presence of cancer early, even before the patient experiences any symptoms, so that it can be caught early and treated in time and its spread may be prevented.

 

The investigations included in Prostate Cancer Screening are the following:

 

  • PSA(Prostate Specific Antigen)
    • ​It is a blood test. PSA is produced by Prostate gland. Its level in blood is checked through this test. PSA level is increased in men due to the conditions affecting their Prostate gland. Besides Prostate Cancer, higher PSA levels can be seen in Prostate gland enlargement, Prostate gland infection, as a result of certain medicines and some medical procedures. Age and race also have influence on PSA levels. However, a higher PSA level generally points towards prostate gland condition. Your surgeon is the best person to interpret the PSA readings so as to plan his next step ahead and perhaps carry out other investigations such as Biopsy of the prostate gland, in case of abnormal PSA finding, to look for presence of Prostate Cancer.
  • ​DRE(Digital Rectal Examination)

    • ​DRE involves insertion of gloved, lubricated finger inside the rectum to look for any palpable abnormal mass or lump in the prostate, felt through rectum. This examination is carried out by either doctor or nurse.

​​

Q12 What tests are done to ensure that the prostate cancer has not spread beyond prostate gland?

 

A12 The tests that are carried out to find out the status of Prostate cancer, its risk of spread and its spread already taken place beyond the prostate gland, are the following:

  • PSA

  • Biopsy

  • CT scan

  • USG

  • MRI scan

  • Bone scan

 

Q13 What can the patient expect after Radical Prostatectomy Surgery?

 

A13 After Radical Prostatectomy Surgery, the patient needs to stay in the hospital generally for 1 to 3 days. Urinary catheter(Foley's catheter) is kept in place for few days that may extend to few weeks in some patients. Pain medicines prescribed by your surgeon effectively control pain post surgery. You may require some time for your urinary continence and sexual function to resume. This time may be from few weeks to few months. Regular follow up with your doctor is needed just to make sure that cancer has not reverted.

 

 

Q14 How successful is Radical Prostectomy in curing Prostate Cancer?

 

A14 Radical Prostatectomy is indicated as a viable option in treating and possibly curing prostate cancer, when the prostate cancer is limited to the prostate gland. However, in case the prostate cancer spreads to the neighbouring or distant tissues, then surgery is not enough, perhaps not even indicated in certain cases. You may require other forms of treatments for prostate cancer under such conditions. Your doctor is the best person to decide the best treatment protocol for you after determining your cancer stage and your medical condition.

 

Generally, it is observed that in men with organ confined prostate cancer, without any evidence of cancer spread, have 85% possibility of surviving more than 10 yrs after Radical Prostatectomy.

Benefits of Laparoscopic Radical Prostatectomy Surgery in India

 

  • Team approach- Holistic approach is taken with multidisciplinary team of specialists contributing their expertise right from the screening,diagnosis,treatment and follow up.

  • Low cost coupled with quality.

  • No waiting period.

  • World class hospitals with state of the art infrastructure.

  • Most advanced diagnostic and treatment methods are employed for optimal results.

  • Globally trained doctors with decades of experience in carrying out the surgery with competence and ease.

  • Great ambience

  • Compassionate staff to look after

  • Hospitals accredited with international organizations such as JCI(Joint commission International) for quality standards.

  • Language no barrier. English speaking people and if required, translators are available for your convenience

  • Most economical accommodation available at a walking distance from the hospital. Wide range of options starting from guest house, service appartments to five star hotels, best suited to your budget and choice.

  • Good flight connectivity

  • India has a diverse and rich cultural heritage. You can witness its beauty and uniqueness. It offers most conducive environment for recuperation.

Dr Gagan Gautam

MBBS, DNB,MS,M.Ch(Urology) AIIMS

Fellowship(Robotic Urological Cancer Surgery) Chicago, USA

Head of Urologic Cancer Surgery(Urologic Oncology) and Robotic Surgery

Max Cancer Centre, Max Hospital, Saket,New Delhi

 

Dr Ashish Sabharwal

MBBS,MS(General Surgery), DNB(Urology)

Fellowship in Endourology and Robotic Prostate Surgery(Miami,Florida,USA)

Senior Consultant in Urology and Andrology

Fortis Escorts Heart Institute, New Delhi

Special Interest in:

Robotic Surgery for Prostate cancer,HIFU treatment for prostate cancer

Laser surgery,TURP for BPH

Treatment for Erectile Dysfunction and Penile Implants

 

 

Dr Sanjay Gogoi

MBBS, MS(General Surgery), DNB(Genitourinary Surgery),M.Ch(Urology)

Director and Head of the Dept. Urology and Renal Transplant

Fortis memorial and Research Institute,Gurgaon,Delhi-NCR

 

 

Dr Soumyan Dey

MBBS, MS(General Surgery), MCh(Urology)

Consulting Urologist and Uro-Oncologist

Wockhardt Hospital, Mumbai

 

Dr Roy Chally

MBBS, MS, MCh(Urology)

Senior consultant Urologist and HOD

Baby Memorial Hospital, Kozhikode(Calicut),Kerala

 

 

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