Robotic Surgery

Robot assisted laparoscopic prostatectomy is typically performed in less than two hours, there is minimal blood loss and the procedure is done through tiny incisions leading to a quicker recovery. Many patients are up and walking the same day and home within two days.The aim with this surgery is to achieve complete removal of the cancer whilst preserving urinary control and erection function – the trifecta.

The Da Vinci robot is controlled using two joystick-like arms and several foot pedals. These controls move robotic arms that can be fitted with a variety of different tools. Typically an incision of one to two centimeters allows three or four arms to enter into the patient’s body.

The controls then convert every five centimetres of my movement to one centimetre of movement inside the patient – this allows for improved fine motor actions. In theatre the surgeon sits at a console station manipulating the controls and using the built in ultra high definition monitor to view and complete the surgery.

Single Port Robotic Surgery

Single-port (SP) surgery is just a slightly less invasive way of performing multiport robotic radical prostatectomy. The world results are similar to multiport results but with a slightly quicker recovery in selected cases¹. I performed the first Single Port Robotic Prostatectomies in NSW on 12^th Jan 2026, and the initial patients have done extremely well. It is used in my practice selectively where I feel that the tumor and priorities of the patient in terms of speed of recovery is paramount. I certainly do not use it if there are high-grade advanced cancers and there are certain criteria for using it, such as the nature of the tumor, the low level of likelihood of extracapsular disease, the size of the prostate and the presence of a hostile abdomen (multiple previous operations) which would make multiport surgery more difficult^1,2. This requires a detailed discussion with Prof Stricker.

My current criteria for SP Robot RP currently are:

Prostate size under 50cc
Intermediate grade cancer (ISUP Grade 2 or 3 – Gleason 3+4 or Gleason 4+3)
High priority on speed of recovery rather than my established results of Multiport RP
Concerns with respect to Multiport RP such as multiple previous abdominal operations
Avoid SP if previous laparoscopic hernia surgery OR severe obesity OR high-grade cancers OR need to perform Lymph gland sampling

Ficarra V, Romito I, Sorce G, Maravigna D, De Stefano A, Mottrie A, Abdollah F, Viganò S, Stabile A, Salonia A, Giannarini G, Crocerossa F, Gandaglia G, Montorsi F, Rossanese M. Comparison of Single- and Multiport Robot-assisted Approaches in Prostate and Renal Surgery: A Systematic Review and Meta-analysis. Eur Urol. 2025 Dec;88(6):589-613. doi: 10.1016/j.eururo.2025.08.010. Epub 2025 Sep 27. PMID: 41016915.
Soputro NA, Kaouk J. Single-port robot-assisted radical prostatectomy. World J Urol. 2024 Apr 20;42(1):245. doi: 10.1007/s00345-024-04914-5. PMID: 38643347; PMCID: PMC11032265.

Advantages of Robotic Prostatectomy

The Da Vinci robot has revolutionised surgery and thousands of patients have benefited from the use of this technology. With miniature incisions and a laparoscopic approach robotic surgery offers:

Quicker return to normal activity
Shorter hospitalisation
Reduced risk of incontinence and impotence
Less blood loss
Reduced pain, most patients do not require pain medication after discharge.

This state-of-the-art surgical procedure can offer the best chance for complete recovery. Wristed instrumentation, tremor filtration and 3D magnification aid in performing one of the most demanding aspects of the procedure — nerve-sparing for preservation of sexual function and continence.

Who Can Have Robotic Surgery?

Some patients are better suited for robotic surgery, however the prostate cancer must be confined to the prostate gland.

Patients who have had a stroke or cerebral aneurysm are not candidates for robotic prostate surgery, as the surgical table is titled head-first at a 45° angle for the one to three hour procedure. And some cardiac and pulmonary disorders exclude patients from robotic prostate surgery such as angina, congestive heart failure, severe restrictive lung disease, asthma or cardio-obstructive pulmonary disease and any condition requiring supplemental oxygen.

Other factors include severe glaucoma, hip disease or a disorder that’s not compatible with the surgical position and obesity.

Q&As

When can I have sex?

It is recommended to wait four weeks before having sex. Please remember that most patients will be able to climax but there will be no ejaculate.

When can I return to work?

Most patients are able to return to work within one to two weeks and nearly all activity can be resumed by four weeks. Men with occupations that require heavy lifting will need to be on light duties for four to six weeks.

When will I know if all the cancer has been removed?

I will assess recovery, remove the catheter and review the final pathology report with the patient at the first follow-up appointment, which are usually four to seven days after surgery.

When will I be able to have an erection again?

Everyone is different. Some patients start having erections very soon after surgery while others take up to two years. However, my team has consistently demonstrated superior outcomes with the maintenance of sexual function. Each patient is encouraged to see the nurse at my practice who will answer questions.

Why a Robotic Radical Prostatectomy?

Traditional radical prostatectomies require either a large incision with unpleasant side effects or feature limited vision and dexterity. At St Vincent’s, I can provide the best opportunity for full recovery from prostate cancer. Experience demonstrates that a robotic radical prostatectomy successfully overcomes these shortcomings and offers patients improved benefits, including minimal risk of incontinence and impotence.

Why should I choose St Vincent’s Private Hospital?

St Vincent’s Private Hospital was the first hospital in NSW to perform a DaVinci robotic radical prostatectomy in 2005 and today we have the latest model of the machine. The early adoption of this highly advanced laparoscopic prostate cancer treatment demonstrates its commitment to providing world-class healthcare.