Robotic-Assisted Prostatectomy

Robotic-assisted laparoscopic prostatectomy (RALP) is the gold standard surgical treatment for clinically localised prostate cancer, removing the entire prostate gland and seminal vesicles through small abdominal incisions with the assistance of the da Vinci Surgical System. The robotic platform's three-dimensional magnified visualisation and wristed instrument articulation enable precise dissection around the neurovascular bundles responsible for erectile function and the external urinary sphincter — the critical determinants of functional outcomes after prostatectomy.

At SilverOak Health, all RALP procedures are preceded by multiparametric MRI and targeted transperineal biopsy to accurately characterise tumour location, grade, and extent, informing the nerve-sparing strategy. Bilateral nerve-sparing is performed whenever oncologically safe — when tumour is confined away from the prostatic capsule on both sides — as bilateral preservation maximises the probability of erectile function recovery. The vesico-urethral anastomosis is constructed using a running suture technique that provides a watertight repair enabling catheter removal within five to seven days in most cases.

Our RALP programme consistently achieves positive surgical margin rates below 10% for pT2 disease and below 25% for pT3 disease, reflecting careful patient selection and technical precision. Urinary continence — defined as zero pad use — is achieved by 90% of patients at 12 months, with continence recovery rates superior to published open prostatectomy series. Patients are supported through the recovery process by our urology specialist nurses, who provide catheter care education, pelvic floor physiotherapy referral, and regular post-operative follow-up including PSA monitoring to detect early biochemical recurrence.