The complete removal of the prostate (radical prostatectomy) is a possible therapy when the cancer is contained inside the prostate. This operation is at present the most frequently used and proven method. It is the method for the treatment of localised prostate cancer for which the most experience has been gathered.
Various surgical procedures
At the Martini-Klinik, two surgery techniques for the complete removal of the prostate (radical retropubic prostatectomy) are offered.The full, open-surgical removal of the prostate, the so-called radical retropubic prostatectomy. In this procedure, the prostate is removed via a small incision in the lower abdomen. The operation is performed with micro-surgical technology and microscopic enlargement.
Minimally-invasive, robot-assisted surgery with the da Vinci or Hugo-RAS operation system. With the world-wide most modern laparoscopic operation system, the surgeon operates with the help of an “operation robot” which has at its disposal micro-surgical instruments and a camera system providing a three-dimensional picture. Four da Vinci operation systems are installed in the Martini-Klinik.
Being able to offer both surgical procedures in order to achieve the good results with regard to cancer recovery rates, continence and potency is an advantage of the Martini-Klinik. Either of the surgical procedures can be used to suit the individual patient’s symptoms. For most patients, both methods are equally suitable.
In order to preserve potency, the prostate is first carefully separated from the very fine layer containing the vascular and nervous structures that serve the erectile function; then the prostate is removed and its borders are immediately examined by an experienced uro-pathologist during the course of the surgery at the Martini-Klinik. Only when he microscopically determines that the tumor has crossed the capsule is tissue carefully removed at the places affected – always with the aim to preserve the maximum amount of potency (the NeuroSAFE technique).
In order preserve continence, a surgery method for the complete protection of the urethral sphincter was developed at the Martini-Klinik. Although a significant part of the urethral sphincter protrudes into the prostate, we are able to preserve the entire functional length of the urethral sphincter as well as the entire anatomical embedding of the sphincter within the anatomy of the pelvic floor (the FFLU technique).
Thus, in most cases, both continence and potency remain as they were prior to the intervention.
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