robotic prostatectomy

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ridgewalker
New Member


Date Joined Mar 2010
Total Posts : 7
   Posted 4/11/2010 7:02 AM (GMT -6)   
 
 
Hello again and thanks for all that responded to my first inquirey. I am so glad I found this site.  You are the best people and I wish you all success.
 
does anyone know the following:
Is the prostate actually removed during robotic prostatectomy?
How many holes are put into ones stomach and how are the holes made?
When wearing pads are mentioned are these adult diapers or....?
How long do U have to wait to be able to drive for several hours?
How long must one wait to begin physical work?
65 years
3+4=7  gleason 
6.1   psa
1 of 20 positive in biopsy
bone scan negative
 
 

Mavica
Regular Member


Date Joined Jun 2008
Total Posts : 407
   Posted 4/11/2010 9:56 AM (GMT -6)   
These have been my experiences:

1. My prostate was removed in its entirety when I underwent surgery via the da Vinci robotic method.
2. I think there were 5 holes and though I don't recall with certainty, my recollection (I was sleepiing at the time) the holes were cut by the surgeon(s).
3. Post-op, no two guys experience the same leakage problems - from what I read here. Post-catheter, I used pads for men during the daytime and leak-proof briefs overnight, then as the leaking subsided I learned that various strength pads designed for women worked better for me. My leakage was very heavy at first - 10 to 12 heavy duty mens pads daily - then subsided to one think pad for women.
4. Driving with a catheter is uncomfortable and illadvised, and that's what my surgeon told me. Once the catheter is out I think you have to listen to your body and assess your reaction time for safety purposes (particularly applying pressure in the braking process). Sitting gets easier as the weeks progress. A several hours drive would probably have taken me a month to prepare for.
5. I returned to work 3-weeks post-op. I sit at a desk about 8 hours daily, am up and down walking, walked up and down stairways, rode the public transit system, etc. I do not do lifting or otherwise "physical" work.

I hope some of this helps.

Mavica

Age:  60 (58 at diagnosis - June, 2008)

April '08 PSA 4.8 ("free PSA" 7.9), up from 3.5 year prior

June '08 had biopsy, 2 days later told results positive but in less than 1% of sample (Gleason's 3+3=6)

Developed sepsis 2 days post-biopsy, seriously ill in hospital for 3 days

Dr. recommended robotic removal using da Vinci; Surgery 9/10/08

Northwestern Memorial Hospital, Chicago, IL; Dr. Robert Nadler, Urologist/Surgeon

Post-Op Gleason's:  3+3, Tertiary 4; Margins:  Free ; Bladder & Urethral:  Free

Seminal vesicles:  Not involved; Lymphatic/Vascular Invasion:  Not involved

Tumor:  T2c; Location:  Bilateral; Volume:  20%; Catheter:  Removed 12-days after surgery

Incontinent:  Yes (1 light (woman's style) pad per day)

ED: Combination of Cialis and MUSE (alprostadil) once weekly: started 9-27-08

Returned to work 9-29-08 (18-19 days post-op)

PSA test result, post-op, 10/08: 0.0; 12/08: 0.0; 4/09: 0.0; 9/09: 0.0; 3/10: 0.0

 


142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6946
   Posted 4/11/2010 11:10 AM (GMT -6)   
Ridgewalker,
-Yes, during DaVinci or open removal, they take the prostate, seminal vesicles, and sometimes lymph nodes.

-The surgeon cuts at least five openings, 4 for the robot arms (perhaps 3/4 inch long) and later for the drain, and one for the camera (mine was about two inches). That's the big one, and also the one through which the prostate is taken out. I have six, as my surgeon does an "extra" to allow the nurses a port, so that the arms do not have to be moved in and out as often. Five months post op, two of the small ones have virtually vanished, but the big one never will.

- "pads" are the subject of a lot of posts here (use the search button on the bar near the login button). A lot of us, especially at the unpredictable period after the catheter is removed, have used a diaper - better said male incontinence underwear - with a pad (male guard, or sometimes a women's pad - they are often cheaper) to catch the worst of the leakage. If you use only the diaper, you may be changing it often in a day, at $1 plus cost per each. So the idea is to use a $.30 pad, change often, but still have the backup of the pant if you have a serious leak. Once things start to settle, you will likely go to guards in your normal jockey shorts. I still use 1-2 guards a day. Most folks get off the pads early, but it is a huge variable. (For the Australians, I apologize for the price quotes - I know they are a lot more expensive down under).

- I was forbidden to drive for about four weeks, due to the extent of surgery. They were concerned that hitting the brakes hard sometimes causes internal stitches to break or tear. It wasn't the driving so much as emergency reaction. You are also considered "under the influence" if you drive while or soon after taking most of the serious pain meds.

- It was about two months before I could stand a long (normally 5 hour) car trip (as driver). Even then it took 7 hours with pit stops.

- It was the same two months before I was taken off the "no lifting over 5 pounds" rule, then another month at "no lifting over 10 pounds".

My work is desk-bound/online, so I was back online Tuesday after surgery on Thursday. The big concern beyond lifting and catheters is heavy pain medications. If you are on them, you should not be making business decisions, or writing emails.

That's my experience.

DaVinci 10/09, age 56

Casey59
Veteran Member


Date Joined Sep 2009
Total Posts : 3172
   Posted 4/11/2010 2:39 PM (GMT -6)   
ridgewalker said...
 
 
Hello again and thanks for all that responded to my first inquirey. I am so glad I found this site.  You are the best people and I wish you all success.
 
does anyone know the following:
Is the prostate actually removed during robotic prostatectomy?
How many holes are put into ones stomach and how are the holes made?
When wearing pads are mentioned are these adult diapers or....?
How long do U have to wait to be able to drive for several hours?
How long must one wait to begin physical work?
My experiences were similar to those already posted, with slight variation and added comment.
 
  • A radical prostectomy (RP) always results in the complete removal of the prostate.  There is no such partial removal, or any cutting of the prostate.  The word "radical" implies complete removal.
  • Holes are NOT put into one's stomach; rather, they are in one's abdomen.  I would suggest going to the da Vinci/Prostate surgery web site and browse around the links to learn more about it.  http://www.davinciprostatectomy.com/index.aspx
  • Apparently, some men have used the "adult diapers."  I never used diapers, but used the "guards", or pads. 
  • Most doctors instruct patients not to drive themselves while wearing the catheter (usually 1-week after da Vinci surgery).  After the catheter is removed, no physical restriction...but most men will be wearing pads (which itself offers no restriction).
  • 6-weeks after da Vinci surgery, I was cleared to return to regular workouts at the Y (running on an elliptical trainer, weight lifting, core workouts, etc).  Any work of a physical nature was ok then.

best wishes...


RickyD
Regular Member


Date Joined Dec 2009
Total Posts : 163
   Posted 4/11/2010 4:21 PM (GMT -6)   
I will add that the DaVinci surgery I just completed at Vanderbilt Medical Center on Wednesday April 7 resulted in 4 holes in the abdomen for robot arms/instruments ( about 3/4 inch in length ) and one larger one (about 1.5 inches long) just above the navel where the camera is inserted. This larger one is where they extract the removed prostate tissue. Also I had a JP Drain for 30 hours. This is a small incision (1/4 inch ) with a small tube traversing along the interior of the abdomen wall to the bladder neck area. It allows blood/fluids to be drained for a short time after the surgery. This was removed just prior to discharge and a small bandage placed over the incision. Also instructed not to drive with catheter in place and no lifting for 4 weeks. I plan to return to work (office work) in about 5 weeks.

Rick
Age 55,  PSA = 4.97 on 11/17/09, DRE negative,
Biopsy 12/2/09: 1 of 12 cores positive with less than 5% volume
Gleason 3 + 3 = 6
Prostate Size Estimate on 12/2/09 = 28 cc
RALP is scheduled for April 7, 2010 at Vanderbilt University MC with Dr. Joseph Smith (over 3000 RALPs)


Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3732
   Posted 4/12/2010 5:46 AM (GMT -6)   
Hey Ridgewalker

1)Is it removed? Yes. Supposedly. But how can I tell? I just know I don't squirt anymore so it must be. 56 grams in the biohazard bucket
2) How many incisions? Wait, Let me check..., I'm undoing my belt... 1,2,3,4. My career as a swimsuit model is over.
3) Adult diapers or what? I started with adult diapers. Now using Depends Mens guard pads stuck in my tighty whities. 3-4 per day
4) Driving for several hours? It took me about 1 month. I kept a urinal, clean water, diapers, wash cloths, blue pads, and a change of clothing in the car. I had to pee every 30 minutes. (And messed up the seat more often than an old dog going to the vet.)
5) Physical work? I was good to go in about 3 months. But I peed all over myself any time I lifted anything more than about 10 pounds. Unfortunately I still do. Splitting wood is a laugh riot. Not.
At 9 months, I am still incontinent but I am far in the minority. Your numbers are much better than mine so hopefully you'll be much better off.

You've got an interesting hiking path to follow. Even though there are problems, the view is much better on top of the grass. Keep your boot treads clean my friend.

Jeff
Married 34 years, DX Age 56. First routine PSA test on April 8, 09: 17.8. Start 2 weeks of Cipro to rule out protatitis. May '09 PSA: 22.6, 3 weeks later: PSA: 23.2.
Biopsy 6/10/09: 7/12 scores positive, 20%-70%, Gleason 6=3+3. Bone and C/T scans neg.
RP DaVinci -7/21/2009 @ Univ of Roch Medical Center
Left nerve gone, right partial spared.
Catheter removed - 7/31/2009 Pathology report received:
Gleason 3+4=7, Tumor size: 2.5 x 1.8 cm, location: both lobes and apex.
Extraprostatic extension present; Perineural invasion: present, extensive.
No Malignancy in Seminal Vesicle, vasa deferentia, lymph nodes 0/13
Prostate mass 56 grams. Pathologic Stage: pT3aN0MX
Post Surgery Status:
Potency - 12/11 5 months, Still no activity, zip. Using pump daily since 11/11. No effect with 20 mg of Cialis or 100 mg of Viagra. Shots next See Uro 1/22/10 Trimix #1. Try 0.08- 25%, 0.12-25%, 2/26/10 try 0.16 First Success! 90%.
Incontinence - 8/20 4 full pads per day
.. 9/7 3-4 full pads per day (Try cutting down on fluids. Bad idea. I know.)
12/11/09 5 months: 3 pads per day, 400-450ml/day
02/26/10 7 months: 3 pads but leak is now 320 ml (5 day avg.)
03/22/10 8 months: 3 pads per day, 280 ml/day (5 day avg.) PT says all muscles are tight and working properly. There must be another issue. Uro mtg 4/23. Did I waste 6 months?
Post Surgery PSA - 9/3 6 weeks - 0.05; 10/13 3 months - 0.04, 1/14 6 months - 0.05.

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