Best Radical Prostatectomy Surgery Hospitals in India

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Best Radical Prostatectomy Surgery Hospitals
in India
What is a prostatectomy? A prostatectomy could be
a surgical procedure for the partial or complete
removal of the prostate. its going to be
performed to treat prostate cancer or benign
prostatic hyperplasia. A common surgical
approach to prostatectomy includes creating a
surgical incision and removing the prostate gland
(or a part of it). this might be accomplished
with either of two strategies, the retropubic or
suprapubic incision (lower abdomen), or a
perineum incision (through the skin between the
scrotum and therefore the rectum).Prior to
having a prostatectomy, its typically necessary
to own a prostate biopsy.

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Types of surgery There are several ways of
removing the prostate. Keyhole surgeryKeyhole
surgery (also called laparoscopy or minimally
invasive surgery). Keyhole surgery by hand your
surgeon makes five or six small cuts in your
abdomen (stomach area) and removes the prostate
using a thin, lighted tube with a small camera on
the tip and special surgical tools. Robot-assisted
surgery your surgeon uses three robotic arms
(one for the camera and two for the surgical
tools) to do the operation. Your surgeon controls
the robotic arms from a computer. You may hear
this called the Da Vinci Robot. Open
surgeryYour surgeon makes a single cut in your
stomach area to reach the prostate. This is
called retropubic prostatectomy.

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• Radical prostatectomy with retropubic
  (suprapubic) approach. This is the most common
  surgical approach used by urologists (doctors who
  specialize in diseases and surgery of the urinary
  tract). If theres reason to believe the cancer
  has spread to the lymph nodes, the doctor will
  remove lymph nodes from around the prostate
  gland, in addition to the prostate gland. Cancer
  has spread beyond the prostate gland if its
  found in the lymph nodes. If thats the case,
  then surgery may be discontinued, since it wont
  treat the cancer adequately. In this situation,
  additional treatments may be used.
• Nerve-sparing prostatectomy approach. If the
  cancer is tangled with the nerves, it may not be
  possible to maintain the nerve function or
  structure. Sometimes nerves must be cut in order
  to remove the cancerous tissue. If both sides of
  the nerves are cut or removed, the man will be
  unable to have an erection. This wont improve
  over time (although there are interventions that
  may restore erectile function).If only one side
  of the bundle of nerves is cut or removed, the
  man may have less erectile function, but will
  possibly have some function left. If neither
  nerve bundle is disturbed during surgery,
  function may remain normal. However, it sometimes
  takes months after surgery to know whether a full
  recovery will occur. This is because the nerves
  are handled during surgery and may not function
  properly for a while after the procedure.

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• Laparoscopic radical prostatectomy. The surgeon
  makes several small cuts and long, thin tools are
  placed inside the cuts. The surgeon puts a thin
  tube with a video camera (laparoscope) inside one
  of the cuts and instruments through others. This
  helps the surgeon see inside during the
  procedure.
• Robotic-assisted laparoscopic prostatectomy.
  Sometimes laparoscopic surgery is done using a
  robotic system. The surgeon moves the robotic arm
  while sitting at a computer monitor near the
  operating table. This procedure requires special
  equipment and training. Not every hospital can do
  robotic surgery.
• Radical prostatectomy with perineal approach.
  Radical perineal prostatectomy is used less
  frequently than the retropubic approach. This is
  because the nerves cant be spared as easily, nor
  can lymph nodes be removed by using this surgical
  technique. However, this procedure takes less
  time and may be an option if the nerve-sparing
  approach isnt needed. This approach is also
  appropriate if lymph node removal isnt required.
  Perineal prostatectomy may be used if other
  medical conditions rule out using a retropubic
  approach.With the retropubic approach, there is
  a smaller, hidden incision for an improved
  cosmetic effect. Also, major muscle groups are
  avoided. Therefore, theres generally less pain
  and recovery time.

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What are the advantages and disadvantages? Advanta
ges If the cancer is completely contained inside
the prostate, surgery will aim to remove all of
it. The prostate is removed and sent for testing
which will give a clearer picture about how
aggressive the cancer is and how far it may have
spread. It is easy to measure the success of your
surgery, as your PSA should drop to less than 0.1
ng/ml at six to eight weeks after the
operation. If your PSA starts to rise, you may be
able to have radiotherapy or hormone
therapy. Disadvantages There are risks in having
a surgery, as with any major operation. You will
need to stay in hospital this may be for one to
seven days. If the cancer has broken out of the
prostate, the surgeon may not be able to remove
all of it. You wont be able to have children
naturally after surgery.

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• Before the procedure
• Some things you can expect before the procedure
  include
• Your doctor will explain the procedure to you and
  offer you the opportunity to ask any questions
  you might have about the procedure.
• Youll be asked to sign a consent form that gives
  your permission to do the procedure. Read the
  form carefully and ask questions if something
  isnt clear.
• In addition to a complete medical history, your
  doctor may perform a physical examination to
  ensure youre in good health before you undergo
  the procedure. You may also undergo blood tests
  and other diagnostic tests.
• Youll be asked to fast for eight hours before
  the procedure, generally after midnight.
• Notify your doctor if youre sensitive to or are
  allergic to any medications, latex, iodine, tape,
  contrast dyes, and anesthetic agents (local or
  general).
• Notify your doctor of all medications (prescribed
  and over the counter) and herbal supplements that
  youre taking.

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• Notify your doctor if you have a history of
  bleeding disorders or if youre taking any
  anticoagulant (blood-thinning) medications,
  aspirin, or other medications that affect blood
  clotting. It may be necessary for you to stop
  these medications prior to the procedure.
• If you smoke, you should stop smoking as soon as
  possible prior to the procedure in order to
  improve your chances for a successful recovery
  from surgery and to improve your overall health
  status.
• You may receive a sedative prior to the procedure
  to help you relax.
• Based on your medical condition, your doctor may
  request other specific preparation.

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During the procedure Radical prostatectomy
requires a stay in the hospital. Procedures may
vary depending on your condition and your
doctors practices. Generally, a radical
prostatectomy (retropubic or perineal approach)
follows this process

• Youll be asked to remove any jewelry or other
  objects that may interfere with the procedure.
• Youll be asked to remove your clothing and will
  be given a gown to wear.
• Youll be asked to empty your bladder prior to
  the procedure.
• An intravenous (IV) line will be started in your
  arm or hand.
• If there is excessive hair at the surgical site,
  it may be clipped off.
• The skin over the surgical site will be cleansed
  with an antiseptic solution.
• The anesthesiologist will continuously monitor
  your heart rate, blood pressure, breathing, and
  blood oxygen level during the surgery.

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• Once youre sedated, a breathing tube may be
  inserted through your throat into your lungs and
  youll be connected to a ventilator, which will
  breathe for you during the surgery.
• The doctor may choose regional anesthesia instead
  of general anesthesia. Regional anesthesia is
  medication delivered through an epidural (in the
  back) to numb the area to be operated on. Youll
  receive medication to help you relax and
  analgesic medication for pain relief. The doctor
  will determine which type of anesthesia is
  appropriate for your situation.

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After the procedure After the procedure, you may
be taken to the recovery room to be closely
monitored. Youll be connected to monitors that
will constantly display your heart
beat (electrocardiogramECG or EKG) tracing,
blood pressure, other pressure readings,
breathing rate, and your oxygen level. You may
receive pain medication as needed, either by a
nurse, or by administering it yourself through a
device connected to your intravenous line. Once
youre awake and your condition has stabilized,
you may start liquids to drink. Your diet may be
gradually advanced to more solid foods as youre
able to tolerate them. The drain will generally
be removed the day after surgery.

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