British doctors have pioneered a new type of robotic surgery for prostate cancer, allowing patients to recover in weeks instead of months.
The technique involves an incision in the perineum – the undercarriage area between the legs – rather than in front of the pelvis as in the standard NHS method.
Urologists at University College London Hospital are offering the surgery and say the approach minimizes blood loss and the risk of bowel damage, and reduces post-operative complications like urinary incontinence.
TV and radio presenter Bull Turnbull, who died of prostate cancer last week, had spent his final years battling the disease
Traditionally, surgery for prostate cancer left patients suffering from side effects such as erectile dysfunction and incontinence
The new robotic technology allows doctors to reduce the harm associated with treating the patient
Accountant Mark McDerment, 51, who was one of the first patients to benefit, was dealing with work calls the morning after his surgery and was discharged from the hospital a day later.
The married father of three from High Easter, Essex, underwent surgery in March after being diagnosed with prostate cancer last year. “I feel like I’ve recovered well,” he says. “Within a couple of weeks I was back to London by car and train.”
In the UK, around 52,000 men are diagnosed with prostate cancer each year and almost eight in ten men survive a decade or more.
Last week, former BBC breakfast presenter Bill Turnbull died nearly five years after being diagnosed with advanced prostate cancer.
If the cancer is caught early, grows slowly, and isn’t causing symptoms, patients can simply be monitored with regular testing—known as watchful waiting and active surveillance—rather than receiving more aggressive treatment.
However, if the cancer is in a later stage or if the tumor is aggressive and there is a risk of it spreading, surgery, radiation therapy, and drugs are options. These can be offered individually or in combination.
The prostate is a walnut-sized gland that sits under the bladder. Due to its location, treatments often carry the risk of causing incontinence. Surgery can also damage the nerves that supply the penis, which can lead to erectile dysfunction.
Surgery to remove the prostate — known as a radical prostatectomy — is traditionally performed through a single large incision or a keyhole operation involving multiple smaller incisions in the lower abdomen. The latest method is robot-assisted keyhole surgery. During the procedure, the surgeon controls a multi-armed machine that holds instruments, and proponents say it allows for more precise movements.
Historically, prostatectomies were performed via the perineum, allowing for a more direct route to the prostate. However, the location of the incision made it difficult for surgeons to see what they were doing, and the method was all but abandoned by the 1990s.
But with the advent of robotic keyhole surgery, experts have been able to revive the method.
Urologist Christopher Ogden, who is part of the pioneering team developing the approach, says: “If you enter through the front of the abdomen, you have to travel more than a foot to get where you need to be. You’ll need to get the bowels out of the way and usually dissect the pelvic floor — the layer of muscle that helps control bladder activity. This can affect continence. If you go in via the dam, you only have to cover a few centimeters. It’s child’s play.’
The method is particularly helpful for patients who have had previous abdominal surgery, such as B. An appendectomy or hernia repair, where a buildup of internal scar tissue can make entry through the front more risky.
Mr Ogden adds: “In standard surgery, patients stay in hospital for two or three nights and take six to eight weeks to recover. With the new approach, we keep patients indoors for one night, but it could be done as a day case.
“Men say they’re back to normal within weeks.”
Mr McDerment was told he was an ideal candidate for the new technique as previous surgeries on his abdomen had left many scars. Six months later, he feels mostly normal again. The main problem was erectile dysfunction, which is very common after prostate surgery.
“The surgery affected my love life – it changed my life in that way,” he says. “But I have treatment for it and I know it’s a matter of time and healing.”