How is radical prostatectomy performed?
Radical prostatectomy can be performed as an open or laparoscopic surgery. For open surgery, the surgeon cuts the abdominal wall or the perineum to access the prostate directly. The prostate and the seminal vesicles are removed.
In locally-advanced prostate cancer, the surgeon will also remove any other tissue that is affected by the tumour.
Then, the bladder and the urethra are attached together (Fig. 1b). The doctor inserts a catheter to help the urethra and bladder heal. Usually the catheter is removed after 7 days.
In laparoscopic surgery, the surgeon inserts small plastic tubes into your abdomen. Through these tubes the surgeon can insert the instruments needed to remove the prostate. One of the small tubes is used to insert a camera which allows the surgeon to see a high-quality image of your prostate on a video monitor. Laparoscopic surgery can also be done with the help of a surgical robot system.
For the removal of a localized tumour or a locally-advanced tumour with radical prostatectomy, open and laparoscopic surgery appear to be equally effective.
Pelvic lymph node removal
If the cancer could spread or has spread to lymph nodes in the pelvic region, your doctor may decide to remove pelvic lymph nodes during radical prostatectomy.