When prostate cancer is caught in the early stages, prostate removal might be the best solution.

For early prostate cancer, removal of the prostate is often the best course of action, which will get rid of the entire tumor as long as it is still confined to the prostate.

If prostate cancer is caught in the early stages, and is still contained to the gland itself, then prostate removal is a good treatment option.

For many patients suffering from prostate cancer, prostate laser surgery is an option they might want to look into. Why?

Laparoscopic prostatectomy is a surgical procedure used to treat prostate cancer.

Open Prostatectomy is the prostrate surgery performed to remove a greatly enlarged prostrate gland. This surgical procedure is called Open Prostatectomy as the incision has to be made by the doctors in the patients abdomen to remove the prostrate tissue unlike the other endoscopic procedures for treating enlarged prostrate where a tube is inserted through the urethra to remove damaged prostate tissues.

Open Prostatectomy is advised by doctors for complicated prostate enlargement cases, where great inflammation is seen, if the patient has gall bladder stones or if his bladder is damaged. In Open Prostatectomy the inner portion of the prostate gland causing enlargement is removed leaving the outer portion of this walnut shaped gland intact.

Problem Symptoms and Purpose of Conducting Open Prostatectomy

A number of changes are observed in the prostrate gland as the age of the male increases. This gland is just the size of a pea at birth and reaches it full shape when the man reaches his mid twenties. No problem is seen in the gland till mid forties, when due to sudden hormonal imbalance in the male's body the cell multiplication starts in the prostate gland causing its enlargement. This problem is commonly known as BHP (Benign Prostatic Hyperplasia). The problem symptoms include:

• Pain or burning sensation during urination
• Bladder irritation and increase in urination frequency
• Urine retention and straining to urinate
  

Though doctors try to treat these symptoms using various advanced medicines and non surgical procedures, surgery becomes important if the severity of the problem increases, for example if blood stains appear in urine, bladder stones form or in case of any problem in the kidneys.

Open Prostatectomy is suggested for treating only 2-3% of the complicated cases where the prostate is excessively enlarged and starts weighing between 80-100 gm. Open Prostatectomy cannot be performed on prostate cancer patients or persons with previous history of pelvic surgery.

Different Open Prostatectomy Procedures

There are two different styles of Open Prostatectomy known as retropubic approach or suprapubic procedure. Surgery is performed after giving the patient local or general anesthesia. Local anesthesia is preferred as it reduces blood loss and also decreases the occurrence of complications like pulmonary embolus or deep vein thrombosis.

Retropubic Prostatectomy is preferred over Suprapubic Prostatectomy as:

• During retropubic surgery surgeons get a direct view of the prostrate tumor which helps them in making accurate incisions.
• Due to clear exposure of prostrate it is easier to control bleeding after surgery.
• Also there is almost negligible surgical trauma to the patient's urinary bladder.
  

On the other hand suprapubic procedures are preferred for treating obese patients and also cases having severe bladder complications as in this procedure the urologist has a clear view of the patient's bladder.

Patient's Aftercare

As Open Prostatectomy is a complex surgical procedure the patient has to remain in the hospital for next 4-7 days under the doctors' supervision. Usually for the first few days after the surgery the patient is put on a liquid diet and the surgeon has to closely monitor and keep track of fluid status and urinary output. A urethral catheter is attached to the patient for at least 2-3 days and is removed if no traces of blood are seen in the urine. If all the vital signs of the patient are found to be okay the patient is discharged after 4 days and can resume with moderate activities in just a couple of weeks, though full healing is complete in 4-6 weeks.

Side Effects of Open Prostatectomy

With major medical advancements doctors are able to control the blood loss rate. Patients recovering from Open Prostatectomy may experience urinary incontinence and retrograde ejaculation is observed in quiet a few cases. 3-5% of the Open Prostatectomy patients reports problem of erectile dysfunction.

Almost all cancers can be cured provided they are detected early. For cancerous conditions associated with the prostate there are a number of treatment options one of which is the Perineal Prostatectomy that involves removal of the affected organ. To undergo this surgery it is rather important for the patient to keep himself in good overall health condition. Since a surgeon usually performs an incision in the groin, it is called the perineal approach and hence the name Perineal Prostatectomy. It is also of utmost importance that the surgeon must have enough experience to perform this surgical procedure as the incision is made in that sensitive area of the body which is between the anus and the scrotum.

Perineal Prostatectomy is made less use of than the other form of surgery known as the radical retro pubic prostatectomy.  In the latter case the lymph nodes can be easily sampled unlike the former type of surgery. Incidentally, the lymph nodes are organs that are distributed throughout the body. They trap foreign particles and also contain white blood cells. While undergoing a Perineal Prostatectomy surgery, the surgeon removes the prostate gland and the surrounding tissues too. If this is done smoothly and by a surgeon having a long list of cases to his credit in this form of surgery then it is all well. Perineal Prostatectomy can be performed in two ways. The first one is the open surgery method and the other is by laparoscopy. During laparoscopy the surgeon makes several small incisions in the belly. If the surgeon so wishes and has suspicion of the cancer having spread to the lymph nodes, then he may make several incisions to remove the lymph nodes. Likewise he may forego that particular incision if he feels that the lymph nodes have not been affected. For this specialized equipment called the laparoscope is used.

There is no denying the fact that Perineal Prostatectomy by and large is never really free of problems as several post surgery cases have suggested. Some of the most widely reported issues are erectile dysfunction, involuntary flow of urine and damage to the rectum especially if the surgery is complicated in cases of advanced prostate cancer. In fact, at times there is the loss of control over the bowels. Due to such associated problems the patient may end up dissociating himself from social interactions and refrain from leading a normal and regular lifestyle. Some may also need to be attended to by a full time nursing staff.

Perineal Prostatectomy is performed under general anesthetic and it also requires a hospital stay of 2 to 4 days. After the incision, the surgeon implants a thin tube called the catheter. This the patient carries with him for 1 to 3 weeks. This is in order to drain out the accumulating urine voluntarily. Actual bladder control might take several months after the removal of the catheter. Even after a successful surgery by Perineal Prostatectomy, the patient must go for periodic check ups to ensure that everything is in order. This is mainly because there are chances of the cancer returning back as has been detected in several cases.

Like all major surgeries, it would be advisable to keep a few things in mind such as history of illnesses, heart problems, other medical conditions and drug allergies. Ensure that the doctor you choose to go to has a successful track record as far as the actual surgical procedure is concerned. Only when the doctor is completely aware of your condition, lifestyle and other important factors can both of you be able to work towards relieving you of your ailment and let you lead as normal a life as would be possible post your Perineal Prostatectomy.

Surgery of any type can be frightening, and the choice between new surgical techniques and traditional ones may be difficult. Traditional surgery with a large incision into the body providing the surgeon plenty of operating room is often painful and may require a long recovery period. If you have chosen to have surgery to treat your prostate cancer, be sure to educate yourself on the different types of surgery available. This article should not be used as medical advice, but rather a general overview of basic information. Discuss all treatment options with your doctor, and seek professional medical assistance for all illnesses.

Evolution
In the beginning of the 20th century veterinarians and doctors began making smaller incisions on their patients to do exploratory surgery. Since it was difficult if not impossible to see inside these incisions extensive surgery was not possible. With continued research and advanced technology, methods were developed by which a small camera could be placed inside the minimized incision giving the surgeon ample viewing capabilities by watching a screen showing what the camera was transmitting from within the body.

Incision Size
Laparoscopic surgery differs from traditional surgery mainly by the size of the incision needed to perform the operation, and is often called keyhole surgery. Much smaller incisions are made in keyhole surgery for prostate cancer. A series of 5 incisions are made which are measured by centimeters rather than inches. A tube is placed in one these incisions to pump carbon monoxide gas into the abdominal cavity. This provides space for the surgeon to obtain a clearer view once the laparoscope camera has been inserted.

Laparoscopy Advantages
Since incisions are smaller bleeding is reduced considerably and hospital stays are usually shortened depending upon your condition. Pain is diminished and prescription pain medication is often unnecessary. Many patients use only over the counter pain relievers.

Preparing for Surgery
You should discuss any concerns you have about your choice of surgery with your doctor. He can best answer your questions with specifics related to your individual case. He will instruct you on how to prepare for surgery, what procedures will take place, and what you can expect during recovery. If you have any special requests now is the time to let your choices be known as it is often difficult to change procedures on the day surgery is scheduled.

After Surgery
Post operative procedures are basically the same for keyhole surgery as traditional. However, your healing time and pain level will be diminished. A draining tube will be removed during one of your follow up visits. With keyhole surgery this can often be accomplished a week earlier than with traditional surgery. This type of surgery is relatively new for prostate cancer and it has not yet been determined if other postoperative symptoms and side effects are also diminished.

Effects of Laparoscopic Surgery
You may find it somewhat difficult to walk during the first couple of days after surgery. The gas used to inflate the abdominal cavity does not completely dissipate after surgery and may push on your diaphragm causing pain in different areas your body. This pain is transient and will diminish as your body absorbs the leftover gas.

Technological advances can be exciting as well as frightening. Be sure to understand the procedure you are about to participate in. Discuss similar cases of other patients with your doctor. Talk to the patients themselves when possible. These discussions can go a long way in calming your apprehensions and quieting any anxieties you may have. You may wish to join a support group. Check with your hospital for suggestions or start one of your own.

TURP or Transurethral Resection of the Prostrate is basically a kind of prostrate surgery, which involves the removal of some section of the enlarged prostrate gland. It is the most common operation for the condition called BPH (Benign Prostatic Hyperplasia) or in simple terms an enlarged prostate.

BPH is also known by other names such as benign prostatic obstruction and benign prostatic hypertrophy. In this condition, the cells of prostrate undergo enlargement and hinder the flow of urine. The person suffering from BPH experiences difficulty in passing urine.
 
TURP is often recommended to patients with extreme symptoms where even medications have stopped responding. Depending on the severity of the condition an individual can also go in for some other alternative procedures such as:

• Transurethral incision of the prostrate
• Microwave therapy
• Open prostatectomy
• Laser vaporization
• Electrovaporisation

Your surgeon can help you choose the most apt procedure depending upon your existing medical condition. He will also guide you in getting prepared for that particular operation. For instance, if you are an active smoker then you will be asked to quit smoking, as it increases the risk of complications, infections and slow recovery.

Most of the prostrate procedures are done under GA (general anesthesia), which means you will practically sleep through the entire duration of operation. Some of the patients may opt for getting operated under epidural or spinal anesthesia. This allows the patient to stay awake during the operation but without feeling any pain. You can discuss with your surgeon about the type of anesthesia that would be best for you before you go ahead.

Usually with the TURP operation it takes about an hour and a half to carry out the whole procedure. Transurethral resection of the prostrate is carried out with the help of an endoscope (flexible, narrow, tube-like telescopic camera). This device is inserted in the urethra (the passage that connects the urinary bladder with penis and through which the urine comes out). The surgeon then cuts and removes the enlarged prostrate with the help of specific surgical instruments. During the operation, the urinary bladder is flushed using some sterile solution to take out the prostrate tissue.

The patient is made to rest until the effects of anesthesia get over. Usually the patients are unable to move the lower portion of their body for several hours in the case of epidural or spinal anesthesia. Patients are then provided with pain killers to eliminate any discomfort and pain that usually crops up with the wearing off of anesthesia. A catheter is also attached for the convenient draining of the urine from the urinary bladder into the bag. The catheter even serves the purpose of washing out the sterile solution from the bladder. The catheter is removed as soon as the urine starts running clear, which usually happens within two to three days of being operated.

After removing the catheter, the patient is encouraged to move around in order to prevent chest infections and the formation of blood clots in legs. The patient is allowed to go home after four to five days. It can take up to 6-7 weeks to recover completely from Transurethral Resection of the Prostrate (TURP). Normal activities may be resumed after two or three weeks. But you must keep in mind to avoid any strenuous activity during the recovery period.

It is always better to go along with the surgeon's advice strictly during the post-operative period. Some particular side effects such as blood in semen or urine, burning sensation while passing urine, urine leakage and retrograde ejaculation might also be experienced in some cases. It is always better to approach your doctor whenever you observe any such unusual signs after the operation. 

Surgery has come a long way from the use of ether as anesthesia and searing to stop bleeding. Robotic-assisted laparoscopic surgery appears to involve all the latest technology and scientific knowledge available. Laparoscopic surgery, also known as keyhole surgery got its start early in the 20th century. Later when cameras which transmit inner body pictures to a screen outside the body were added surgery became more comfortable for a lot of patients. Now the ability of a machine or robot to perform the surgery has been added to the procedure.

Laparoscopic surgery began as a way for vets and doctors to perform exploratory surgery without making large incisions in their patients. The small incision made it difficult to see within the body. The use of the camera makes it possible to see within the body. Even with these advancements surgery is still a risky business. The carbon monoxide gas used to inflate the body cavity to allow the doctor a better view does not leave the body readily and some pain can be experienced until the gas is absorbed by the body. Initial incisions are "blind" and organs may be torn or punctured. Although the doctor may view the inside of the body on the screen he must be careful to make extremely small and precise movements to avoid injury to the patient.

The robotic element of robot-assisted laparoscopic surgery allows for more precise movement and a more stable environment. The robot is a stabilized mechanism which holds the tools required for surgery. The surgeon controls the robot from a comfortable vantage point permitting more controlled movements and better viewing ability. Since all viewing and monitoring equipment is stabilized the surgeon is given a clearer and more perfect view of what is taking place inside of the body.

Radical prostatectomy has been used by itself as means to treat prostate cancer when the tumor is small and contained within the prostate. The procedure involves completely removing the prostate. This can cause nerve damage. It has been suggested that laparoscopic radical prostatectomy may prove to obtain better results than the traditional form of the surgery.

Since this type of surgery is done "from afar" surgeons must complete extensive training beyond normal surgical training. Imagine dropping a small object into a crevice which completely blocks your view. Now a friend demonstrates how you can see and recover this object by using a specially formed mirror and grasping device. In your mind's eye retrieve your object. All of your movements will be foreign to you, and the task practically impossible. This special type of surgery has opened up fields for highly trained specialists. It has been suggested that it may take upwards of 60 surgeries before a doctor will begin to become comfortable with the procedure and 250 surgeries before he becomes an expert.

The advancements in modern technology are astounding. Surgery no longer requires large incisions and extended sedation. Instead we look forward to the expanded use of robot-assisted laparoscopic surgery. Patients often return home in the evening on the same day if the surgery is performed early enough in the morning. Prescription painkillers are often unnecessary. Patients still need to rest and should not overexert themselves. Caring for the body is still a major part of any surgery. However, languishing in bed for days on end because of a surgical procedure may soon be a thing of the past.

There is a long learning curve for the robotic procedure. It is estimated that about 60 cases need to be performed by a surgeon to be comfortable with the procedure and about 250 cases to be an expert.