Treatment of localized prostate cancer by Laparoscopic Radical Prostatectomy

The incidence of prostate cancer is much less in India than in western world. Unfortunately, due to lack of awareness, the prostate cancer is detected when it is already beyond curative treatment.

 
 
 
 
ABOUT DR AJAY SHARMA
PROSTATE CANCER TREATMENT
RECONSTRUCTIVE UROLOGY
LAPAROSCOPIC OPERATIONS
PATIENT EDUCATION
CASE STUDIES
 


 FREQUENTLY ASKED QUESTIONS
WHAT IS LAPAROSCOPIC SURGERY ?

Laparoscopic surgery is what is commonly known as key hole surgery. This is done by special instruments and a video - camera system, and the operation is done by seeing it on a TV screen.

This gives an enlarged view of structures and the operation can be done more cleanly.
The surgeon's hands remain outside, a long cut it not required for accommodating the surgeon's hands.

Since the cut is small, the pain is minimized to a great extent. The cut sometimes is enlarged only for removal of organ or the part of it, which can be done by few centimeter incision. ( 4 -8 cms only.)

The cut for any open or conventional operation for kidney is about 15 to 25 cms to over a foot in obese person.

When reconstruction is done, i.e. organ is not removed, the largest cut is not more than 1.5 cm.

 

 

What are the advantages of Laparoscopic surgery?

All the advantages are related to much smaller cut on the body and clear and enlarged vision under which the surgery is performed.
The biggest advantage is :-

NO UGLY SCARS and MUCH LESS PAIN
This means :-
Less amount of pain killers.
Early start of activity.
Early discharge.
Early recovery and early return to the work. 
Much less chances of wound infection and hernia.
Better body image
Less blood loss, since the vision of operative area is better.

 

 

 

 

Is laparoscopic surgery more costly than conventional surgery?

NO.
The increased cost of equipments is compensated by 
- saving on duration of hospital stay
- need for less medicines

 

Which operations of the kidney can be done by laparoscopy?

For MOST OF KIDNEY OPERATIONS , laparoscopy has already become the operation of choice. These are -
- Removal of Non - Functioning kidney due to any cause.(NEPHRECTOMY)
- Removal of kidney due to cancer
- Removal of PART of kidney due to small cancer
- Correction of obstruction leading to swelling of kidney - Pyeloplasty for UPJ obstruction.
- Chyluria, 
- Large Cysts,
- Special situations for stone like large ureteric stone.

In 21st century, the question is not "Why laparoscopic surgery" but to ask the surgeon " WHY OPEN SURGERY"

 

Which other urologic operations can be done by laparoscopy?

Operation on adrenal gland
Operation for some early cases of Cancer Bladder and Cancer Prostate.
Varicocele operation in cases of male infertility.
Reconstructive surgery on ureter or bladder

 

Is laparoscopic surgery less complete that conventional or open surgery?

It is a myth that disease /organ is left behind if done by laparoscopy.

In fact in most situations, the surgeon can do a better job due to improved and enlarged vision by the help of camera and screen. There is less bleeding so the operative area is cleaner. These factors add together for a more complete job.

Why one should ask for laparoscopic surgery ?

Fortunately, today, most of the kidney operations can be done by this method. Today,one needs to ask "Why open surgery"
Laparoscopic surgery has replaced open surgery in many situations due to less morbidity i.e. the patients feel less sick for lesser duration. 
This makes the experience of undergoing an operation less painful and more convenient

One can easily understand this by seeing the pictures of real patients who underwent laparoscopic operations. One can also interact with these patient ask their experiences..

 

 

SOME MYTHS AND FACTS :-
Myth : Laparoscopic surgery cannot be performed on very old patients and young children.
Fact : Age is no bar. Successful operations have been done on patients as young as 6 months and as old as 90 years.
Myth :- In cancer disease, laparoscopic surgery can not remove the whole cancer.
Fact :- Due to magnification, the removal of cancer is more comprehensive. In fact laparoscopic surgery is finding its maximum value in cancer surgery which can be very morbid if done by standard open surgery.
Myth :- Open surgery is better because surgeon can see better with his own eyes
Fact :- Laparoscopy provides upto 20 times magnification. Hence the surgeon can identify structures much more clearly for a precise operation without causing bleeding.
Myth :- Open surgery is the Gold standard.
Fact :- Today the gold standard in gall bladder, kidney and adrenal gland surgery is laparoscopy. In near future laparoscopic pyeloplasty and prostatectomy are likely to be accepted as gold standard. Laparoscopy has come into being to overcome the shortcomings and disadvantages of open surgery and as improvement over open surgery.

DR AJAY SHARMA
Senior Consultant Urologist
Sir Gangaram Hospital, Rajinder Nagar
, New Delhi, India
Phone : 0124-2386786 , (91-124-2386786). Mobile – 9810154841
Vist our official website
 

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