What is a robotic radical prostatectomy?

Written by: Professor Greg Shaw
Edited by: Conor Lynch

Top Doctors recently spoke to Professor Greg Shaw, a highly respected consultant urologist. Here, in this article below, he details what a robotic radical prostatectomy is, and how exactly it is performed.

What is a robotic radical prostatectomy?

Robotic radical prostatectomy is a minimally invasive (keyhole) operation, performed by a surgeon using the Da Vinci robot, to remove a cancerous prostate gland. The operation is used to cure prostate cancer which has not spread. After the prostate has been removed, the surgeon reconnects the bladder to the urethra (the urine tube passing through the penis) with a stitch.


What’s involved in the procedure and how long does it take to recover?

The procedure involves a general anaesthetic and an overnight hospital stay. After surgery, patients wear a catheter and take simple painkillers like paracetamol and ibuprofen, for a week or so. Deskwork or working from home can start a few days after surgery, but patients often find their energy levels are low for a few weeks after surgery and they should take some time out to recover


What is quality of life can a patient expect after a robotic radical prostatectomy?

Quality of life is expected to be very good after robotic prostatectomy. In the short term, there are some limitations. Patients can resume normal sporting and leisure activities a month after surgery except for riding a bicycle which should avoided for two months after surgery (the saddle presses on the area of the joint (anastomosis) that is made inside the pelvis and is uncomfortable). In the medium and long term, there should be little or no impact on ability to perform and enjoy the activities that you did before surgery.


How can a robotic radical prostatectomy negatively impact on a patient’s quality of life, and how is this addressed?

The two main issues after robotic prostatectomy are urine leakage and problems with erections. Tailored surgical technique using modifications like NeuroSAFE and nerve and urethral sparing are designed to promote the recovery of sexual and urinary function. Proactive penile rehabilitation under supervision allows patients to resume sexual relations early in their recovery as described above.


Is a robotic procedure more beneficial than a traditional radical prostatectomy?

The recovery rate and risk of complications is so much better with robotic prostatectomy that, in the UK, open surgery is only recommended in those rare cases when robotic surgery is not possible (very obese patients or patients who have had multiple open surgeries on their abdomen where a lot of internal scarring is present). The cancer cure rate is as good with robotic surgery as with a traditional open radical prostatectomy.


What is the survival rate for patients who have had a robotic radical prostatectomy?

The operation of robotic radical prostatectomy is generally safe and major complications are rare (much less than one per cent). With robotic prostatectomy, the chance of curing prostate cancer is very good (around 80 per cent at five years will have no sign of active cancer).


The chance of cure is better for low-risk cancer, but worse for high-risk cancer. The cancer risk is defined by the PSA level, the grade and stage of the tumour. After surgery, the PSA level is checked regularly. The PSA level is expected to drop to very low (“undetectable”) levels and if it starts to rise above 0.2ng/ml, then it gives an early warning that further treatment might be required.


This further treatment is usually with hormones and radiotherapy which gives another chance to cure the cancer. Even if a cancer recurs after radical prostatectomy, the chance of dying from prostate cancer within 10 years is low. This is because, if surgery, or indeed, subsequent radiotherapy, fail to cure the cancer, drug treatments can be used to control the cancer for five to 10 years in almost all cases.


To schedule an appointment with Professor Greg Shaw today, simply head on over to his Top Doctors profile.

By Professor Greg Shaw

Professor Greg Shaw is a highly-respected and globally-recognised consultant urological surgeon based in London who specialises in prostate cancer, in particular robotic surgery, prostatectomy alongside urinary tract infection and urinary problems. He practises at The Prostate Centre, near Harley Street, while his NHS base is University College London Hospitals NHS Foundation Trust.

Professor Shaw is highly qualified with a BSc, MBBS and MD from the University of London, as well as an MRCS, FRCS (Urol) from the Royal College of Surgeons of England. After developing an interest in prostate cancer whilst undertaking his MD, he began his specialist urologist training in North London where he was awarded his urology fellowship.

Following this, he completed a four year lectureship at The University of Cambridge where he worked in a world-class research team, generated important research findings and was awarded a fellowship in robotic surgery.

Professor Shaw has performed over 1,100 robotic radical prostatectomies to date and strives to evaluate and incorporate the best technical modifications to attain excellent results. He prides himself in his very low complication rate.

Furthermore, he has developed several research collaborations including an enhanced recovery program for radical prostatectomy at his NHS base, safely increasing the number of patients being discharged home the day after robotic prostate removal. He also has developed and presented a novel surgical technique called complete urethral preservation during robotic assisted radical prostatectomy (RARP) which gives many patients immediate urinary continence.

Professor Shaw, who is a spokesperson for The Orchid Cancer Appeal, is a Professor of Urology at University of College London where he is leading the NeuroSAFE PROOF study to evaluate the cost effectiveness of the NeuroSAFE procedure during radical prostatectomy and the C-PRO-META study to evaluate the prognostic utility of circulating tumour cells in men undergoing surgery for prostate cancer. He has been awarded prizes for lectures delivered at international and national conferences, and one research project he conducted led to significant media interest including a front page article in The Daily Telegraph alongside global press coverage.

Professor Shaw's reputation clinical research also extends to his work as lead for Urology for the National Institute for Health Research (NIHR) for North Thames, while he was also involved in staff training for the NHS Nightingale Hospital in London. Furthermore he is a research consultant for the Royal College of Surgeons of England and has been a Clinical Studies Group member for the National Cancer Research Institute (NCRI).

Professor Shaw has published over 85 PubMed-linked papers, authored several book chapters and various other peer-reviewed articles. Furthermore he's the Associate Editor for uro-oncology for the British Journal of Urology International Knowledge project, where the team has developed an online curriculum supporting urology trainees and established consultants in their continued professional development.

Professor Shaw is a member of various professional organisations including the British Association of Urological Surgeons (BAUS), the European Association of Urology (EAU) and the Royal College of Surgeons of England.

View Profile

Overall assessment of their patients

  • Related procedures
  • Sexually transmitted infections (STIs)
    Penis Enlargement (Phalloplasty)
    Adult circumcision
    Urologic Oncology
    Geriatric Urology
    Kidney transplantation
    Short frenulum
    This website uses our own and third-party Cookies to compile information with the aim of improving our services, to show you advertising related to your preferences as well analysing your browsing habits. You can change your settings HERE.