Similar to standard laparoscopic procedures, the lower abdomen is filled with carbon dioxide gas. The back-pressure created by this gas reduces blood loss and gently sweeps bowel away from the site where the surgeon is operating. The gas is not harmful, does not affect cancer cells in any way, and is exhaled away after surgery. The enhanced visibility and magnification of the robotic cameras aid the surgeons in finding small blood vessels before they bleed, which translates into lower blood loss.
The day prior to surgery you need to be on a clear liquid diet and drink one bottle of fleets phosphosoda. The morning of surgery a fleet's enema needs to be given. This is done to empty the intestines of stool and reduce the risk of bowel related complications.
Operating time averages 2 2.5 hours but it can be slightly longer depending on the difficulty of the case. The time you will be away from your loved ones is a few hours longer because of the prep time in the operating room and the recovery time at the end of the case.
Hospital stay is often less than 24 hours. This can vary, however, depending on how each individual recovers.
Urinary Catheter - You will have a catheter in your penis for about 1 week. This diverts the flow of urine away from where we delicately sewed things back together and allows the urine channel to heal. Please bring a padded undergarment the day of your follow-up appointment. After catheter removal it will be very difficult for you to hold your urine. While your catheter is in it can cause irritation of the bladder which you may sense as urges to go to the bathroom, pain below your pubic bone, or leakage of urine around the catheter. This is normal and there are medications you can take to help reduce this occurrence, just call the office for assistance.
Drainage Catheter - An additional drainage catheter will be placed in the right side of the abdomen. This catheter is typically removed before going home.
Pain - Most individuals after da Vinci robotic prostatectomy have some "gas" like pain the night after surgery and feel like they did too many sit-ups. Most patients report that a pain medication similar to Motrin is sufficient when they go home, however, each will be prescribed an additional stronger pain medication that some patients use as needed to further reduce what discomfort they may have. This should decrease day by day.
Activity - Although you will not be pain free, people feel very good after da Vinci robotic surgery. Light activity can be resumed within 24 hours. Please remember that although you feel good on the outside, a lot of delicate work has been done on the inside and you need to wait 2 weeks before returning to full activity. Feel free to take showers and walk as much as is comfortable, including going up and down stairs. Do not soak in a bath or pool, however.
Medications Your surgeon may prescribe an antibiotic for you to take just prior to the catheter being removed, please follow the prescription instructions. You will also be given a stool softener, it is suggested that you take this until your bowel movements are soft and regular. After any surgery the bowels tend to take some time before returning to regular function. Take your stool softener twice a day for a full month after the surgery to help your body get back into a usual routine. A pain medication will also be prescribed to use as needed. If this is too strong Motrin, Advil, ibuprofen, or Tylenol may be used.