Jeffrey Cadeddu, M.D. Answers Questions On: Prostate Cancer

Outcomes of robotic prostatectomy for prostate cancer can vary tremendously by surgeon. Generally, postoperative pain is mild and my patients are discharged home the next day. Though most surgeons send the patient home with a penile urethral catheter to drain the bladder for one week, I do not. At the end of the surgery, I place a suprapubic tube (a small catheter in the bladder above the pubic bone) to drain the bladder for five to six days after surgery. This avoids the penile urethral catheter, which is often the worst part of the patient's recovery. I have been doing this for over 10 years, and patients are very pleased, as the discomfort is much less. I estimate that 95 percent of my patients undergoing robotic prostatectomy end up with urinary control the same as they had before the surgery, and up to 75 percent have potency restored to the point of being able to have intercourse. 

UT Southwestern was the 7th institution in the U.S. to acquire the newest robotic system, called the SP robot. Rather than making four robotic instrument incisions and two assistant surgeon laparoscopic incisions (for a total of six incisions), I have been using this new Single Port system in which all the robotic instruments are inserted through a single one-inch incision above the belly button. Along with just one small assistant incision, patient satisfaction and pain are improved and recovery is even easier. In 2018, we were the first to start using this system In Texas and we now do so routinely. 

For several years we have also been using novel magnetic tools to assist with conventional and SP robotic prostatectomies to reduce the number of incisions and thereby risk and pain.