Paoli, PA da Vinci FAQ

James Bollinger MD

Dr. James Bollinger of Paoli, PA performs da Vinci surgeries. Read some of the most frequently asked questions about this procedure below.

Q: What is robotic prostate surgery?
A: Referred to by many as robotic surgery for prostate cancer or robotic prostatectomy, da Vinci® Prostatectomy is more accurately a robot-assisted, minimally invasive surgery that is quickly becoming the preferred treatment for removal of the prostate following early diagnosis of prostate cancer. In fact, studies suggest that da Vinci Prostatectomy may be the most effective, least invasive prostate surgery performed today. The robot, called the da Vinci Surgical System, is used to assist in surgical removal of the prostate by providing three-dimensional vision, magnification and an articulating robotic wrist.

Q: Does the robot perform surgery by itself?
A: No. It simply recreates the actions performed by the surgeon at the console in a more precise manner. The instruments only move if and when the surgeon decides to move them. The surgeon is in control of the instruments and not the robot.
Q: What if the robotic equipment fails during the surgery?
A: This is a highly unlikely scenario, but in the event that the robot mechanically fails during surgery, the procedure would be completed with either conventional laparoscopic or open surgery.

Q: How do I know if I am a candidate for da Vinci (robotic) Prostatectomy?
A: Potential candidates for the da Vinci procedure should ideally be under 75 years old and weigh less than 350 lbs. In addition, previous pelvic radiation or multiple abdominal surgeries will make you ineligible for this procedure. If you meet this criteria, we would like the opportunity to present you with some of the potential benefits of the da Vinci Prostatectomy option. Most patients who are candidates for open surgery would have an excellent outcome with this procedure.

Q: Why should I choose robotic prostatectomy instead of traditional open surgery?
A: If your doctor recommends surgery to treat your prostate cancer, you may be a candidate for da Vinci Prostatectomy. This new, less-invasive surgical procedure utilizes a state-of-the-art surgical system that helps your surgeon see vital anatomical structures more clearly and to perform a more precise surgical procedure. For most patients, robotic prostatectomy offers numerous potential benefits over open prostatectomy, including:

• Shorter hospital stay
• Less pain and pain medication
• Less blood loss and transfusions
• Less scarring
• Faster recovery
• Quicker return to normal activities

As with any surgery, these benefits cannot be guaranteed, as surgery is both patient- and procedure-specific. While prostatectomy performed using the da Vinci Surgical System is considered safe and effective, this procedure may not be appropriate for every individual.

Q: Will my insurance cover the da Vinci surgery?
A: The majority of insurance companies pay for this surgery as they would the traditional open or laparoscopic prostatectomy; however there are exceptions. Please consult with your carrier to confirm your coverage prior to surgery.

Q: How long does the operation take?
A: Typically, the procedure itself will take 2-3 hours, although unusual circumstances could increase the time required.

Q: Will I need to donate blood to have available during my robotic prostatectomy?
A: One of the many benefits of da Vinci surgery is minimal loss of blood. Therefore, it is not necessary to have your blood available for transfusion.

Q: Does the robotic prostatectomy surgery require general anesthesia?
A: Yes. Although the da Vinci Prostatectomy offers many advantages compared to conventional surgery, it is still major surgery, requiring general anesthesia and a hospital stay.

Q: How long will I have to stay in the hospital after surgery?
A: The average patient stay is 2.5 days with the majority of patients leaving within 2 days. Many robotic prostatectomy patients are able to go home within 24 hours after surgery.

Q: How soon can I resume normal activities?
A: Every patient is different, and healing time depends on your particular circumstances. Some of the major advantages of this surgery are decreased bleeding and decreased pain which results in a faster and easier recuperation time. Most individuals undergoing this operation will be able to resume normal activities within 7 days of surgery.

Q: How soon can I bathe after the surgery?
A: You may shower after you get home, but bathing in the tub is not recommended for the first two weeks. Treat the incision sites carefully and pat them dry, rather than rubbing.

Q: Will I have a urinary catheter after the surgery?
A: Yes. A urinary catheter is required to ensure adequate bladder drainage and facilitate healing. Your catheter will probably be removed within 4-5 days after the cystogram has been removed.

Q: Will I have normal urinary control after this procedure?
A: Most individuals experience some incontinence immediately following catheter removal, but urinary control generally returns with time. Practicing Kegel exercises can further help control urinary stress incontinence.

Q: Will I be able to resume normal sexual relations after this procedure?
A: Not immediately, although erectile function returns for most patients within 9 to12 months. Some patients are able to resume sexual intercourse within a shorter time. You may temporarily require the additional assistance of prescription medication. Although all individuals are different, your doctor will work closely with you to ensure the best possible outcomes after surgery, including sexual function.

Q: Will I be sterile (unable to father children) after this procedure?
A: Yes. All patients who have a radical prostatectomy, regardless of the type of surgery used, will be sterile after the prostate is removed.

Q: How many of these procedures has Dr. Bollinger performed?
A: Dr. Bollinger has performed more than 800 open, laparoscopic and robotic surgeries, of which over 300 of them are robotic surgeries.

Contact Dr. James Bollinger today at 610-296-0810 for all of your Paoli, PA Urology needs.