Robotic Assisted Radical Prostatectomy (RARP), also known as Robotic Assisted Laparoscopic Prostatectomy (RALP), is a surgical procedure to achieve cure of prostate cancer.  General outcomes of the procedure are excellent with high cancer survival rates.

A detailed information leaflet from the British Association of Urological Surgeons is available here.

The procedure will remove your whole prostate gland and the seminal vesicles which are attached to the prostate. Chances of complete cure are usually very high after this procedure, although it depends on the grade and stage of disease. 

Online resources are plentiful and we encourage you to watch a couple of conceptual videos of the RARP procedure from the European Association of Urology and Seattle, US.

Where will the surgery be carried out?

Mr Yamamoto will carry out the procedure at Eastbourne District General Hospital as a private case under his care.

What should I be doing before surgery?

You should start pelvic floor muscle exercises 3 times a day. We recommend a smart phone app called Squeezy for Men which gives you helpful advice on how to perform these exercises effectively.

How long will I be in hospital?

Treatment will usually involve an overnight stay in hospital, but occasionally a longer stay may be required.

Will I leave hospital with a catheter?

Yes, you will leave hospital with a catheter which will be removed at 7-10 days after surgery.  You will be instructed on how to look after your catheter.  If you have any problems with the catheter, or immediately after catheter removal, please inform Mr Yamamoto immediately via the resident team based at the Nuffield.

How mobile will I be immediately after surgery?

You will be able to walk around the house and to go for short walks outside. We do not advise to drive your car for at least two weeks, and until you feel confident with making all necessary manoeuvres.  

What are the typical symptoms during recovery?

  • Pain from the small keyhole surgery scars on your abdomen usually lasts for around 2 weeks and can be controlled with simple painkillers such as paracetamol or ibuprofen. You also may feel pain in your shoulders due to the use of carbon dioxide gas inside your abdomen which irritates the nerve and muscle of your diaphragm. Such pain will resolve within several days.  

  • Constipation is very common immediately after surgery due the strong pain medication you receive during and after surgery.  We encourage you to take laxatives early to avoid constipation and straining your bowels. 

  • Urinary frequency and urgency is common after removal of your catheter. This will usually settle after several weeks.  If you experience persistent burning or pain when passing urine you should contact us to test for a urinary tract infection.

  • Urine leakage may occur following removal of your catheter. This is typically minor and controlled with a thin pad. More than 90% of our patients have good urinary control immediately. The remainder of patients will recover over several weeks to months. It would be very rare for one to be left with permanent significant leakage (1%). In such a case you will still be able to achieve full continence but will require additional surgery.

  • Erectile dysfunction is a frequent consequence of the operation. In selected patients we can use a technique called "nerve-sparing" during surgery to help preserve your of erectile function. Maximum nerve-sparing can result in 60-70% of patients achieving good erectile function after the operation. The ability to nerve-spare depends on the location, grade and stage of your cancer and is not possible in all patients.

  • Tiredness is very common up to 4 weeks.

How long should I avoid exercise after surgery?

You must avoid physical exercise for 6 weeks to minimise the risk of a wound hernia. This includes running, gardening, golf, swimming, and cycling. You can still go outdoors for short walks and must continue pelvic floor exercises 3 times a day.

What are the general follow up plans after surgery?

  • 1 week post surgery: removal of your catheter in hospital.

  • 4 weeks: review of progress and histology discussion.  

  • 6-7 weeks: review of your PSA test result and recovery.

  • Subsequent follow up involves 3 monthly PSA tests in the first 12 months, then 6 -12 monthly depending on the results.

The table below represents the risks and outcomes of robotic assisted radical prostatectomy performed by Mr Yamamoto at Eastbourne District General Hospital.

Complications of Robotic Assisted Laparoscopic Prostatectomy*
  Urinary incontinence beyond 1 year (requiring corrective surgery)
  Wound hernia
  Bladder neck stenosis
  Urine leak requiring prolonged catheterisation
  Blood transfusion0%
  Lymphoedema / lymphocoele<1%
  Conversion to open surgery0%
  Rectal /bowel injury
  Cancer recurrence, needing further treatment**

*The data above is accurate as of March 2023 and shows the results of all operations carried out by Mr Yamamoto since the start of robotic surgical services in 2017.

**This is an average number combining all patients with different cancer risks.  Higher risk cancer will be associated with higher risk of recurrence.