Robotic Radical Prostatectomy

Robotic Radical Prostatectomy is a minimally invasive surgical procedure designed for the removal of a cancerous prostate gland. It’s performed using advanced robotic technology, most notably the da Vinci® Surgical System.

This system enhances the surgeon’s capability in terms of precision, vision, and control during the operation.

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What is Robotic Radical Prostatectomy

The procedure involves making several small keyhole incisions in the patient’s abdomen, through which miniaturised robotic instruments are inserted to remove the prostate and, if necessary, surrounding tissues such as the seminal vesicles and nearby lymph nodes. The operation uses robotic arms and wrists that provide the surgeon with greater dexterity and accuracy, improving the outcomes of the surgery.

Indications for Robotic Radical Prostatectomy

Robotic Radical Prostatectomy is primarily indicated as a treatment for prostate cancer that is confined to the prostate gland. This procedure is particularly recommended when the cancer has not spread to other parts of the body, making it a viable option for localised cancer management.

The decision to opt for this surgery typically depends on various factors, including the stage and aggressiveness of the cancer, the patient’s overall health, and the presence of any contraindications to surgery. This procedure offers a curative approach for patients with localised prostate cancer, aiming to remove the cancerous gland while preserving as much of the normal function as possible.

Procedure Details

The procedure of Robotic Radical Prostatectomy involves a series of steps:

Before the Procedure:

  • Consultation and Preoperative Assessment: Patients undergo a thorough medical evaluation, including imaging and blood tests, to determine the extent of prostate cancer and suitability for robotic surgery.
  • Patient Education and Consent: Detailed discussions about the benefits, risks, and expected outcomes of the surgery are conducted.
  • Preparation Guidelines: Instructions on fasting, medication adjustments, and arranging for postoperative care are provided.

During the Procedure:

  • Anaesthesia Administration: Patients receive general anaesthesia for a pain-free, unconscious state during surgery.
  • Making Incisions: The surgeon makes several small incisions in the abdomen for the robotic arms and instruments.
  • Deploying the Robotic System: The da Vinci® Surgical System is positioned and controlled by the surgeon from a console.
  • Surgical Execution: With enhanced 3D visualisation and precision, the prostate gland and, if necessary, surrounding tissues are removed. The system’s high degree of dexterity facilitates careful dissection and minimises damage to adjacent structures.
  • Bladder and Urethra Reconnection: After the prostate is removed, the bladder is reconnected to the urethra, restoring the urinary tract’s continuity.

After the Procedure:

  • Immediate Postoperative Care: Patients are monitored in a recovery room and then transferred to a hospital room for overnight observation.
  • Catheter Management: A catheter is placed to aid in urinary drainage and is typically kept for about a week.
  • Pain Management and Medication: Pain is managed through prescribed medications, and instructions are given for managing catheter care at home.
    Postoperative Follow-up: Regular follow-up appointments monitor recovery, manage side effects, and evaluate cancer control.


Robotic Radical Prostatectomy offers several benefits over traditional open surgery, including:


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    Less Blood Loss

    Enhanced vision and precision reduce blood loss during surgery.

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    Reduced Pain

    Smaller incisions lead to less postoperative discomfort.

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    Shorter Hospital Stays

    Minimally invasive nature allows for quicker discharge.

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    Faster Recovery

    Patients typically experience a quicker return to normal activities.

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    Improved Surgical Outcomes

    The robotic system's precision aids in nerve preservation, potentially reducing the impact on urinary and sexual functions.

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    Lower Complication Rates

    The refined control reduces the risk of complications during surgery​.

Potential Risks

While Robotic Radical Prostatectomy is generally safer than traditional open surgery, it still carries certain risks, including:

  • Bleeding: Despite reduced blood loss, there’s still a potential for bleeding.
  • Infection: Risk of infection at the surgical site.
  • Damage to Adjacent Tissues/Organs: Precision of robotic arms minimises, but does not eliminate, the risk of accidental damage to surrounding tissues or organs.
  • General Surgical Risks: As with any surgery, there are risks associated with anaesthesia and the body’s response to surgery.

Possible Side Effects

Following Robotic Radical Prostatectomy, patients may experience:

  • Urinary Incontinence: This is an inability to control urine, which can occur post-surgery but often improves over time.
  • Erectile Dysfunction: Postoperative erectile function depends on factors like age, preoperative sexual function, and nerve-sparing during the surgery. Surgeons often use nerve-sparing techniques to reduce the impact on sexual function.

Postoperative Care and Recovery

After Robotic Radical Prostatectomy, the postoperative care and recovery process typically includes:

  • Hospital Stay: Generally, an overnight stay is required.
  • Catheter Use: Patients are fitted with a catheter post-surgery, usually for about a week.
  • Pain Management: Simple painkillers like paracetamol and ibuprofen are often prescribed.
  • Activity Resumption: Desk work or working from home can usually resume a few days post-surgery, though full energy levels may take weeks to return.
  • Monitoring and Follow-up: Regular follow-up appointments are crucial for monitoring recovery and addressing any complications​.

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Dr Lee Fang Jann image

Dr Lee is a urologist and kidney transplant surgeon with a broad-based expertise of all urological disorders

He has subspecialty focus on men’s health and male infertility, and special interest in minimally invasive prostate enlargement therapy and kidney stone treatment. Dr Lee has received numerous awards for service excellence such as the Service With A Heart Award (2006-2008, 2011) and the Singapore Health Quality Service Award (2016).

  • Bachelor of Medicine and Bachelor of Surgery (Singapore)
  • Membership of The Royal College of Surgeons (Edin)
  • Master of Medicine (Surgery) (Singapore)
  • Fellowship of the Academy of Medicine (Urology)
  • Clinical fellowship at Oxford Transplant Centre in the UK

Prior to entering private practice, Dr Lee served in the public sector for 16 years at SGH, where he initiated dedicated clinics evaluating and treating patients with complex men’s health and fertility issues. He also led the Renal Transplant Program and laparoscopic donor nephrectomy service as Surgical Director.

Apart from clinical work, Dr Lee is active in academia and believes in the importance of grooming the next generation of doctor. He was Senior Clinical Lecturer at NUS’ Yong Loo Lin School of Medicine and currently, Adjunct Assistant Professor at the Duke-NUS Medical School. Dr Lee is also regularly invited to share his experiences locally and regionally through lectures, workshops and surgical demonstrations.

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    Frequently Asked Questions

    What is Robotic Radical Prostatectomy?

    A minimally invasive surgery using advanced robotics to remove the prostate gland.

    How can you prepare for Robotic Radical Prostatectomy?

    Preparation typically involves preoperative assessments, fasting before surgery, and arranging for postoperative care.

    What can you expect in a Robotic Radical Prostatectomy?

    The procedure involves small incisions, robotic-assisted removal of the prostate, and typically an overnight hospital stay.

    How long is the procedure?

    The procedure typically takes around 2.5 hours.

    How safe is the procedure?

    While generally safe with a low complication rate, risks include bleeding, infection, and potential tissue damage.

    How does it compare with traditional prostatectomy?

    It offers enhanced precision, less pain, quicker recovery, and potentially fewer side effects than traditional open surgery.

    What side effects can I expect?

    Common side effects include urinary incontinence and erectile dysfunction.

    How long is the recovery period?

    Recovery varies, with an initial short hospital stay and gradual return to normal activities over several weeks.