Robotic Prostatectomy Surgery in Delhi, India

Robot-assisted prostatectomy is a minimally invasive surgical procedure used primarily to treat localised prostate cancer by removing the prostate gland. During the procedure, the surgeon operates using a robotic surgical system that translates their hand movements into precise, controlled movements of specialised instruments through small incisions. The robotic system does not perform the surgery independently. It remains under the complete control of the surgeon throughout the procedure.

The type of robot-assisted prostatectomy recommended depends on the underlying prostate condition and the extent of surgery required. After a thorough evaluation, the urologist will determine the most appropriate approach based on the patient's diagnosis, overall health, and treatment goals. The main types include:

Robot-Assisted Radical Prostatectomy

This is the most common type of robot-assisted prostatectomy and is primarily performed to treat localised prostate cancer. The procedure involves removing the entire prostate gland and, in some cases, nearby lymph nodes if clinically indicated.

Robot-Assisted Simple Prostatectomy

This procedure is typically recommended for men with a significantly enlarged prostate caused by benign prostatic hyperplasia (BPH) when other treatments have not been effective. Unlike radical prostatectomy, only the enlarged portion of the prostate is removed, while the outer part of the gland is left intact.

Robot-assisted prostatectomy may be recommended for specific prostate conditions when surgery is considered the most appropriate treatment option. The decision depends on factors such as the patient's diagnosis, the severity of the condition, overall health, and treatment goals. It is commonly recommended in the following situations:

Localised Prostate Cancer

Robot-assisted radical prostatectomy is most commonly performed to treat prostate cancer that is confined to the prostate gland. The goal of surgery is to remove the cancer while preserving surrounding structures whenever clinically appropriate.

Benign Prostatic Hyperplasia (BPH)

In selected patients with a significantly enlarged prostate, robot-assisted simple prostatectomy may be recommended when medications or less invasive procedures have not provided adequate relief. The surgery removes the enlarged portion of the prostate to improve urinary symptoms while preserving the rest of the gland.

Preparing for robot-assisted prostatectomy involves a detailed evaluation to ensure the procedure is appropriate and to minimise the risk of complications. Before surgery, patients can generally expect the following:

• Medical Evaluation: The urologist will review your medical history, current symptoms, medications, and any existing health conditions. A physical examination and discussion about the expected benefits and potential risks of surgery will also be carried out.
• Diagnostic Tests: Blood tests, urine tests, imaging scans, and other investigations, such as PSA testing or a prostate biopsy review, may be required to assess your condition and plan the surgery.
• Medication Review: You may be advised to stop or adjust certain medications, particularly blood thinners and specific supplements, several days before the procedure. Always follow your doctor's instructions and do not discontinue any medication without medical advice.
• Pre-Anaesthesia Assessment: An anaesthesiologist will evaluate your overall health, review any previous experiences with anaesthesia, and explain the type of anaesthesia that will be used during the procedure.
• Fasting Instructions: You will be instructed not to eat or drink for a specified period before surgery to ensure your safety during anaesthesia.
• Preoperative Guidance: Your healthcare team will explain the surgical process, expected hospital stay, recovery timeline, and post-operative care. This is also an opportunity to ask questions and discuss any concerns before the procedure.

Although the exact technique may vary depending on the type of robot-assisted prostatectomy being performed, the procedure generally involves the following steps:

• Anaesthesia: The procedure is performed under general anaesthesia, ensuring you remain asleep and pain-free throughout the surgery.
• Small Incisions: The surgeon makes a few small incisions in the abdomen to insert specialised surgical instruments attached to the robotic system and a high-definition camera.
• Robotic Surgery: Sitting at a nearby console, the surgeon controls the robotic system, which translates their hand movements into precise movements of the surgical instruments. The robotic system does not perform the surgery independently.
• Prostate Removal: Depending on the condition being treated, either the entire prostate gland or only the enlarged portion of the prostate is carefully removed.
• Reconstruction: The bladder is reconnected to the urethra to restore the normal passage of urine.
• Closure: Once the procedure is complete, the instruments are removed, the small incisions are closed, and you are shifted to the recovery room for monitoring.

Recovery after robot-assisted prostatectomy is a gradual process. During this time, your doctor will provide guidance on different aspects of post-operative care, including:

• Pain Management: Mild pain or discomfort around the incision sites is common and is usually managed with prescribed medication.
• Urinary Catheter: A urinary catheter is typically kept in place for a short period to allow the urinary tract to heal. Your doctor will advise when it can be removed.
• Physical Activity: Light walking is encouraged soon after surgery, while strenuous activities and heavy lifting should be avoided until your doctor advises otherwise.
• Urinary Function: Temporary changes in urinary control may occur after surgery and often improve over time as healing progresses.
• Follow-Up Care: Regular follow-up visits help monitor healing, assess recovery, and discuss pathology results and any further treatment if required.
• Return to Routine: Most patients gradually return to their normal daily activities, although the recovery timeline varies depending on the individual and the type of procedure performed.

Compared to traditional open surgery, robot-assisted prostatectomy offers several potential advantages for suitable patients. Some of the key benefits include:

• Smaller Incisions: The procedure is performed through a few small incisions, resulting in less tissue disruption than open surgery.
• Greater Precision: The robotic system enables the surgeon to perform delicate movements with enhanced precision and control, particularly in the confined space around the prostate.
• Reduced Blood Loss: The minimally invasive approach is generally associated with less blood loss during surgery, reducing the likelihood of blood transfusions.
• Less Pain: Smaller incisions often result in reduced post-operative pain and discomfort compared to traditional open surgery.
• Shorter Hospital Stay: Many patients are able to leave the hospital sooner, depending on their recovery and overall health.
• Faster Recovery: Most patients can resume light daily activities earlier than they typically would after open surgery, although recovery timelines vary.
• Lower Infection Risk: Smaller incisions may reduce the risk of wound-related complications, including infections.
• Better Cosmetic Outcomes: The smaller incisions usually result in less noticeable scarring once healing is complete.
• Improved Functional Outcomes: In suitable patients, the enhanced precision of robotic surgery may help preserve urinary continence and erectile function by minimising damage to surrounding nerves and tissues whenever clinically appropriate.

Like any surgical procedure, robot-assisted prostatectomy carries certain risks and potential complications. Some possible risks include:

• Bleeding: Although blood loss is generally lower than with open surgery, bleeding may still occur during or after the procedure.
• Infection: There is a small risk of infection at the incision sites, in the urinary tract, or within the surgical area.
• Urinary Incontinence: Temporary urinary leakage is common after surgery, while persistent incontinence may occur in a small proportion of patients.
• Erectile Dysfunction: Changes in erectile function may occur if the nerves responsible for erections are affected during surgery. Recovery varies depending on several factors, including age, pre-operative function, and whether nerve-sparing surgery is possible.
• Injury to Nearby Structures: Although uncommon, nearby organs or structures, such as the bladder, urethra, bowel, blood vessels, or nerves, may be injured during the procedure.
• Blood Clots: As with many major surgeries, there is a risk of developing blood clots in the legs or lungs, though preventive measures are routinely taken.
• Anaesthesia Risks: General anaesthesia carries a small risk of complications, including allergic reactions, breathing problems, or cardiovascular events.
• Scar Tissue Formation: In some cases, scar tissue may develop around the bladder neck or urethra, leading to narrowing that may require further treatment.

Robot-assisted prostatectomy requires meticulous surgical planning, technical expertise, and coordinated post-operative care to achieve the best possible outcomes. At Max Hospitals, patients benefit from a comprehensive approach designed specifically for robotic prostate surgery, including:

Experienced Urologists

Robot-assisted prostatectomy at Max Hospitals is performed by experienced urologists with specialised training in robotic and minimally invasive urological surgery. Their expertise allows them to manage both straightforward and complex cases while adapting the surgical approach to each patient's diagnosis and clinical needs.

Advanced Robotic Surgical Systems

Max Hospitals is equipped with advanced robotic surgical technology that provides high-definition, magnified visualisation and enhanced instrument dexterity. This enables surgeons to perform intricate procedures in the confined pelvic region with greater precision and control.

Focus on Functional Preservation

In addition to treating the underlying condition, the surgical team carefully plans the procedure to preserve surrounding nerves and structures whenever clinically feasible. This approach aims to support better recovery of urinary continence and sexual function without compromising the primary goals of surgery.

Multidisciplinary Clinical Care

For patients undergoing robot-assisted prostatectomy for prostate cancer, urologists collaborate closely with medical oncologists, radiation oncologists, radiologists, pathologists, and anaesthesiologists. This multidisciplinary approach ensures coordinated decision-making before surgery and appropriate follow-up care afterwards.

What should I eat before surgery?

Your doctor will provide specific dietary instructions before surgery. In most cases, you will be asked to stop eating and drinking for a certain period before the procedure to ensure your safety during general anaesthesia.

Can I take my regular medications before surgery?

Some medications can be continued, while others, particularly blood thinners, certain diabetes medications, and some supplements, may need to be stopped or adjusted. Always follow your doctor's instructions and do not make any changes without medical advice.

What can I expect in terms of pain after surgery?

It is normal to experience mild to moderate pain or discomfort around the incision sites after surgery. Your healthcare team will prescribe pain medication to help keep you comfortable during the recovery period.

What should I do if I notice unusual symptoms after surgery?

Contact your doctor immediately if you develop symptoms such as persistent fever, severe pain, excessive bleeding, redness or discharge from the incision sites, difficulty passing urine after catheter removal, or sudden swelling or pain in the legs.

What activities should I avoid during recovery?

Avoid heavy lifting, strenuous exercise, driving until your doctor advises it is safe, and activities that put strain on the abdomen during the initial recovery period. Your doctor will let you know when you can gradually resume your normal routine.

Can robotic prostatectomy surgery cause a hernia?

An incisional hernia is an uncommon complication of robotic prostatectomy because the procedure uses small incisions. Following your surgeon's recovery instructions, especially avoiding heavy lifting during the healing period, can help reduce the risk.

What are the long-term effects of robotic prostatectomy?

Most patients recover well and gradually return to their normal activities. However, some may experience long-term changes in urinary continence or erectile function, depending on factors such as age, pre-operative function, the underlying condition, and the extent of surgery. Regular follow-up helps monitor recovery and manage any ongoing concerns.

Reviewed by Dr Anant Kumar, Chairman - Urology Renal Transplant and Robotics of Max Saket Complex and Uro-Oncology of MSSH Saket, Urology, Kidney Transplant, Robotic Surgery , on 8 Oct 2026

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