Robot Assisted Laparoscopic Prostatectomy

WHAT YOU SHOULD KNOW:

Robot-assisted laparoscopic prostatectomy (RALP) is surgery to remove your prostate gland through small incisions in your abdomen. RALP is done with a machine that is controlled by your surgeon. The machine has mechanical arms that use small tools to remove your prostate.


CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

  • You may bleed more than expected or get an infection. Your bladder, ureters (tubes that drain urine from your body), intestines, or rectum could be cut during surgery. After RALP, you may have problems urinating or having bowel movements. You may need more surgery to treat urination problems. You may not be able to have an erection after surgery. Your stitches may come apart. You may have a hernia or develop an abscess (deep infection). Your recovery may take longer if you need larger cuts in your abdomen.

  • You may get a blood clot in your arm or leg. The clot may travel to your heart or brain and cause life-threatening problems, such as a heart attack or stroke. Even with surgery, the cancer may come back.

  • If you do not have the prostatectomy, your signs and symptoms could get worse. Your cancer may spread to other areas of your body and be more difficult to treat.

WHILE YOU ARE HERE:

Before your surgery:

  • Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

  • An IV is a small tube placed in your vein that is used to give you medicine or liquids.

  • Heart monitor: This is also called an ECG or EKG. Sticky pads placed on your skin record your heart's electrical activity.

  • Pressure stockings: These are long, tight stockings that put pressure on your legs to promote blood flow and prevent clots. You may need to wear pressure stockings before or after surgery or if you have poor circulation (blood flow).

  • Enema: You may be given an enema (liquid medicine put in your rectum) to help clean out your bowel.

  • Antibiotics: Antibiotics help prevent an infection caused by bacteria. You may get antibiotic medicine before and after your surgery.

  • General anesthesia will keep you asleep and free from pain during surgery. Anesthesia may be given through your IV. You may instead breathe it in through a mask or a tube placed down your throat. The tube may cause you to have a sore throat when you wake up.

During your surgery:

  • A urinary catheter is put into your bladder to drain your urine. Hair around the surgery site may be removed. The robotic arms place a laparoscope and other tools inside your abdomen through small cuts. A laparoscope is a long, thin tube with a light and camera on the end. A gas called carbon dioxide is pumped into your abdomen to inflate it. This gives caregivers room so they can see your prostate better.

  • Your surgeon uses the camera to see inside your abdomen. He guides the robotic arms to cut the prostate away from other tissues. The prostate is removed through one of the small cuts in your abdomen. Lymph nodes may also be removed. Your surgeon uses the robotic arms to stitch your incisions closed.

After your surgery:

You will be taken to a room where you can rest until you are fully awake. Caregivers will monitor you closely. Bandages over your incisions will help prevent infection. Do not get out of bed until your caregiver says it is okay. Once caregivers see that you are not having any problems, you will be taken to your hospital room.

  • Activity: You may need to walk around the same day of surgery, or the day after. Movement will help prevent blood clots. You may also be given exercises to do in bed. Do not get out of bed on your own until your caregiver says you can. Talk to caregivers before you get up the first time. They may need to help you stand up safely. When you are able to get up on your own, sit or lie down right away if you feel weak or dizzy. Then press the call light button to let caregivers know you need help.

  • Drains: These are thin rubber tubes put into your skin to drain fluid from around your incision. The drains are taken out when the incision stops draining.

  • Foley catheter: This is a tube caregivers put into your bladder to drain your urine into a bag. Do not pull on the catheter, because this may cause pain and bleeding, and the catheter could come out. Keep the catheter tubing free of kinks so your urine will flow into the bag. You will need to keep using a catheter after you leave the hospital. Caregivers will remove the catheter as soon as possible to help prevent infection.

  • You will be able to drink liquids and eat certain foods once your stomach function returns after surgery. You may be given ice chips at first. Then you will get liquids such as water, broth, juice, and clear soft drinks. If your stomach does not become upset, you may then be given soft foods, such as ice cream and applesauce. Once you can eat soft foods easily, you may slowly begin to eat solid foods.

  • Vital signs: Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.

  • Deep breathing and coughing: This will help decrease your risk for a lung infection after surgery.

    • Hold a pillow tightly against your incision when you cough to help decrease pain. Take a deep breath and hold it for as long as you can. Deep breaths help open your airways. Let the air out and follow with a strong cough. Spit out any mucus you cough up. Repeat the steps 10 times every hour.

    • You may be given an incentive spirometer to help you take deep breaths. Put the plastic piece into your mouth and take a slow, deep breath. Let out your breath and cough. Repeat the steps 10 times every hour.

  • Pain medicine: You may be given a prescription medicine to decrease pain. Do not wait until the pain is severe before you ask for more medicine.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Robot Assisted Laparoscopic Prostatectomy (Inpatient Care)

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