Prostatectomy – The prostate surgery that can cure cancer

What is a prostatectomy?

A prostatectomy is the prostate surgery that is performed to remove parts of the prostate or the entire gland. Usually, prostatectomy is recommended for the treatment of prostate cancer.

There are many types of prostatectomy, depending on the approach chosen.  A common approach to prostatectomy involves a surgical incision through which the prostate or part of it is removed. This incision can be done two ways:

  • Through the lower abdomen (retropubic or suprapubic incision)
  • Through the perineum (the skin between the scrotum and the rectum)

In most cases, urologists recommend this procedure for prostate removal after they have performed several prostate cancer diagnosis methods, such as prostate biopsies or PSA tests. 


Better understand the prostate gland and prostate cancer

The prostate is a walnut-sized gland, that surrounds the urethra. It is formed by muscular and glandular cells, with ducts that open in the urethra. Its main function is to secrete an alkaline fluid that compounds the seminal fluid that carries the sperm. During orgasm, the muscles of the prostate expel this fluid into the urethra. This fluid combined with the sperm travel through the tip of the penis during ejaculation.

Researchers have found that the prostate gland plays an important role in both urinary and sexual functions. The most frequent prostate problem is BPH (prostate enlargement), which happens as men age. However, there are also other conditions that can affect the prostate, such as prostate cancer.

Prostate cancer happens when the prostate cells start to divide in an uncontrolled manner. This health problem is a serious concern reason. According to the American Cancer Society, prostate cancer is the most common form of cancer, after skin cancer.

Types of prostate surgery

Here are some prostate surgery options to consider:

1. Robotic radical prostatectomy (RP)

A robotic radical prostatectomy is the removal of the prostate gland by means of a robot. The da Vinci robot is usually employed for such prostatectomies. That is because robotic prostatectomies are nerve-sparing and preserve urinary and sexual functions.

2. TURP procedure

The TURP procedure implies the partial removal of the prostate. The transurethral resection of the prostate is an approach performed through the penis with an endoscope.

3. Laparoscopic surgery

Laparoscopic prostate surgery can be done manually or by a robot. It is another method of prostate surgery.

Different types of radical prostatectomy

There are various types of radical prostatectomy.

  • Radical prostatectomy with the retropubic (suprapubic) approach

This is the most common type of radical surgery performed by most urologists. By means of this procedure, the surgeon can even remove the lymph nodes if they are also affected by prostate cancer.

If cancer has spread into the nervous area, there may be fewer chances to spare the nerves that are related to erection production. In this case, the surgeon may need to cut the nerves on both sides of the prostate, thus losing the erectile function. But if cancer has not spread to the nerves, then the erectile function may come back to normal in a short while.

  • Radical prostatectomy with the perineal approach

Radical prostatectomy with the perineal approach is used less often than the prostatectomy with the retropubic approach. By using this surgical technique, the nerves can not be spared. Also, the lymph nodes can not be removed. However, the advantage of this procedure is that is less time-consuming. Also, it is recommended for men who may not benefit any more from nerve-sparing. Al factors need to be taken into account, as the perineal approach is more painful and esthetically not so good looking.

  • Laparoscopic radical prostatectomy

Laparoscopic radical prostatectomy involves several small incisions through which small instruments are being introduced with a video camera inside.

  • Robotic radical prostatectomy

This is the most advanced type of prostate surgery. It is actually a robotic-assisted laparoscopic radical prostatectomy done by means of a modern medical robot. The surgeon operates a console that dictates the movements of the robotic arms that perform the incisions. Dr. Samadi is highly trained in this type of prostate surgery. Until now, he has performed more than 7000 successful robotic prostatectomies.

As you already know, a prostatectomy is recommended for the removal of prostate cancer. This surgical procedure is performed on patients whose cancer is confined to the prostate. The procedure involves the partial or total removal of the prostate gland, along with the seminal vesicles. The seminal vesicles connect to the vas deferens and secrete semen.

Besides prostate cancer, there may also be other reasons for a prostatectomy, such as prostate bleeding, slow urination, urinary retention, bladder stones, etc.

Robotic radical prostatectomy – The standard in prostate cancer treatment

Robotic prostatectomy is a radical prostatectomy that is also known as Robotic Assisted Laparoscopic Prostatectomy (RALP). It is a minimally invasive prostate removal and cancer treatment surgery.

The robotic prostatectomy system is performed with the aid of the da Vinci robot, one of the most advanced medical robots in the health industry.


This high-tech system allows the surgeon to have improved vision, control, and precise movements.

David B. Samadi, MD, is at the forefront of prostatectomy and prostate removal surgery and has performed more than 7,000+ successful procedures to date. His innovative SMART technique uses robotic prostate surgery enhancements to improve vision and precision. In Dr. Samadi’s skilled hands, patients are assured superior quality of life results in both sex after prostate surgery and urinary control after prostate surgery.

Wtach the video to see how is Dr. Samadi performing a robotic prostatectomy:


The steps of the robotic prostatectomy

Robotic prostatectomy requires 5 small incisions, each about one-quarter of an inch in the lower abdomen, through which instruments are inserted. A sophisticated video camera is one of the instruments, which gives Dr. Samadi a three-dimensional, 10x magnified field of vision. The keyhole incisions drastically reduce blood loss and the camera provides unprecedented visual clarity. The result is a clear surgical field during the prostatectomy with nothing to obstruct Dr. Samadi’s view of the prostate and surrounding tissue.

Cameras are also used in laparoscopic prostatectomy, but they provide only a two-dimensional image and no magnification.

The prostate surgery follows these specific steps:

  1. Keyhole incisions are being made in the patient’s abdomen
  2. Fine robotic instruments are being placed inside the abdomen
  3. A 3D endoscope and an imaging device is being placed inside the abdomen for enhanced precision
  4. The surgeon operates the console to maneuver the instruments so as to cut and remove the prostate
  5. The prostate is being removed through one of the keyholes

SMART Surgery – advanced robotic prostatectomy for prostate cancer

Dr. Samadi developed his signature SMART (Samadi Modified Advanced Robotic Technique) Prostate Surgery, which incorporates oncologic principles, combines it with open radical prostatectomy skills, and builds upon it with a robotic surgery approach.

SMART is a revolutionary and advanced prostate cancer surgery and prostate cancer treatment method, which drastically reduces blood loss, pain, hospital stay, recovery time, and the side effects of other types of prostate cancer treatments. The SMART Technique is also known as bloodless prostate surgery. The SMART Technique does not require opening the endopelvic fascia or cutting the dorsal vein complex. This results in no sutures and less damage to the neurovascular bundle.


Dr. Samadi is able to enter into the patient through a few small “keyhole” entrances and handle the SMART robotic surgery with very tiny and precise instruments that allow him to perform the surgery with great precision and remove the patient’s prostate gland without doing any harm to surrounding tissue. The patient is left with only a few small marks on his abdomen – none of the scars normally associated with prostate cancer treatment and surgery.

Robotic prostatectomy video

Get a glimpse inside the operating room and meet Dr. David Samadi and his OR team while performing a robotic prostate surgery:


What are the benefits of robotic prostatectomy?

Robotic prostatectomy offers several advantages over the traditional laparoscopic surgical method of treating prostate cancer when objectively compared in the following areas:

  • Clinically Superior Results
  • Reduced Risk of Complications
  • Quicker Recovery Period
  • Minimize Scarring

What makes the robotic prostatectomy a superior prostate cancer treatment?

The da Vinci robotic prostate cancer surgery system is able to provide superior clinical prostate cancer treatment results when compared to non-robotic traditional and scope-assisted procedures.

This is because the da Vinci system’s Surgeon Console is equipped to provide the surgeon with a revolutionary, three-dimensional, multi-level magnification spectrum.

More traditional scope-assisted surgery typically provides a much lower resolution image, and a far more limited field of vision. Furthermore, the da Vinci system’s sensitive electronics and one-centimeter diameter surgical arms allow the surgeon to make highly precise movements inside the incision during robotic prostate cancer surgery. This means that the malignant tissue can be removed with efficiency and ease unheard of prior to the era of robotic surgery. This greater precision reduces the likelihood of relapse due to missed cancerous tissue.

The precision of the da Vinci system also allows the prostate surgeon to avoid damaging healthy prostate tissue, which improves clinical results, reduces scar tissue build-up, and contributes to an overall shorter recovery period after robotic prostatectomy.