Santa Barbara's Prostate Cancer Treatment of Choice

Robotic Laparoscopic Surgery

Dr. Laub specializes in robotic-assisted laparoscopic radical prostatectomy using the Da Vinci system. He has been performing robotic prostatectomy since 2005. In contrast to traditional (open) surgery, this procedure is performed through several small incisions in the abdomen using special instruments to reach the prostate. An illuminated viewing instrument called a laparoscope is inserted into one of the openings, and the surgeon maneuvers robotic arms with precise movements to remove the gland through the other incisions.

The goal of using the nerve-sparing technique is to completely excise the tumor and surrounding tissues while carefully cutting around the set of nerves that lead from the prostate to the penis. Leaving these nerves intact sometimes preserves the man's ability to have normal erections within a year after the surgery. As part of the procedure, the urethra—which runs through the middle of the prostate gland—must be cut, and then reattached to the bladder.

You can expect a 2- to 4-day hospital stay, general anesthesia, and a bladder catheter at home for up to two weeks. Follow-up care is essential, including ongoing PSA tests, physical exams, digital rectal exams, and biopsies if needed, to monitor any possible return of this disease.

Nerve-sparing Radical Prostatectomy

When caught early, non-metastatic, localized prostate cancer can be effectively treated using a minimally invasive surgical technique that removes the gland while leaving most of the surrounding nerves intact. This bilateral nerve-sparing radical prostatectomy method was first developed in the 1980s as a way to eliminate cancer while improving the chance of maintaining sexual function in men who undergo surgery.

Success Rates

Unfortunately, it is not possible to determine before surgery whether or not the cancer has spread beyond the prostate. After the procedure, a PSA test can indicate if all of the cancer was successfully removed when the patient’s levels have decreased to nearly zero. However, if the cancer has spread outside of the prostate, then advanced symptoms may develop following the surgery.

Although there are no guarantees, studies have shown that healthy men younger than 65 had higher post-surgery survival rates than men who had radiation therapy.

Risks and Complications

Post-surgical risks of radical nerve-sparing prostatectomy include:

• Erection issues in about 50% of patients. Regaining sexual function generally can take 6 months to one year. Impotence can often be helped with medication or mechanical aids.
• Urinary incontinence, from mild dribbling to continual leakage. Because Dr. Laub has more than 30 years of surgical experience, most of his patients do not experience significant incontinence.

Rehabilitation protocols post-operatively are utilized to maximize return of sexual and urinary function.

Complications include the same general risks as other major surgeries, such as heart problems, blood clots, allergic reactions to anesthesia, infection, and excessive blood loss, as well as damage to the urethra or rectum.

Contact our office for a consultation to determine if a radical nerve-sparing prostatectomy is the right option for your prostate cancer treatment.