{"id":4920,"date":"2026-09-06T22:35:45","date_gmt":"2026-09-06T21:35:45","guid":{"rendered":"https:\/\/www.dumonceau-urologie.fr\/urology\/robot-assisted-radical-prostatectomy-robotic-surgery-explained\/"},"modified":"2026-09-06T22:58:48","modified_gmt":"2026-09-06T21:58:48","slug":"robot-assisted-radical-prostatectomy-robotic-surgery-explained","status":"publish","type":"post","link":"https:\/\/www.dumonceau-urologie.fr\/en\/urology\/robot-assisted-radical-prostatectomy-robotic-surgery-explained\/","title":{"rendered":"Robot-assisted radical prostatectomy: robotic surgery explained"},"content":{"rendered":"\n<div class=\"upo-article\"><p class=\"upo-article__lead\">Treating prostate cancer with precision, preserving quality of life. <strong>Da Vinci Xi robotic surgery explained<\/strong> \u2014 procedure, nerve preservation, recovery, risks and alternatives.<\/p><p class=\"upo-article__byline\"> <span>By <strong>Dr. Olivier Dumonceau<\/strong> , urological surgeon specializing in prostate surgery,<\/span> <span>Urology Practice Paris Op\u00e9ra \u2014 82 Bd de Courcelles, Paris 17th <sup>.<\/sup><\/span> <span>Reading time: 13 minutes<\/span> <\/p><nav class=\"upo-article__toc\" aria-label=\"Sommaire de l'article\"><p class=\"upo-article__toc-title\"> Contents<\/p><ol><li> <a href=\"#et-maintenant\">A diagnosis. And now?<\/a><\/li><li> <a href=\"#comprendre\">Understand before deciding<\/a><\/li><li> <a href=\"#pourquoi-robot\">Why robotic surgery?<\/a><\/li><li> <a href=\"#ambulatoire\">Outpatient since 2016<\/a><\/li><li> <a href=\"#deroulement\">How does the intervention take place?<\/a><\/li><li> <a href=\"#nerve-sparing\">Nerve preservation<\/a><\/li><li> <a href=\"#recuperation\">Recovery, week by week<\/a><\/li><li> <a href=\"#risques\">The risks: complete information<\/a><\/li><li> <a href=\"#indications\">Who is this suitable for?<\/a><\/li><li> <a href=\"#faq\">Your frequently asked questions<\/a><\/li><li> <a href=\"#retenir\">Key takeaways<\/a><\/li><\/ol><\/nav><h2 id=\"et-maintenant\"> A diagnosis of prostate cancer. Now what?<\/h2><p> <em>&quot;Doctor, what do we do?&quot;<\/em> This is the question all patients ask after a diagnosis of prostate cancer.<\/p><p> My first answer: <strong>you have time to make a good decision<\/strong> . In most cases, localized prostate cancer is effectively treated, provided that an informed, and not rushed, decision is made.<\/p><blockquote class=\"upo-quote\"><p> The goal is not to go fast. The goal is to choose the right treatment.<\/p> <cite>Dr. Olivier Dumonceau<\/cite><\/blockquote><p> For over 20 years, I have been performing radical prostatectomies using robot-assisted surgery with the <strong>Da Vinci<\/strong> system. The goal: to treat the cancer precisely, while preserving continence and erectile function as much as possible.<\/p><p> But this surgery is not the only option. Active surveillance, radiotherapy, brachytherapy, HIFU\u2026 all these alternatives exist and should be discussed based on your individual situation.<\/p><div class=\"upo-callout upo-callout--key\"><p> My role is not to steer you towards surgery. <strong>My role is to help you choose what is best for you.<\/strong><\/p><\/div><h2 id=\"comprendre\"> Prostate cancer: understanding before deciding<\/h2><h3> Quick anatomical review<\/h3><p> The prostate is a walnut-sized gland located below the bladder and in front of the rectum. It surrounds the urethra \u2014 the tube through which urine leaves the bladder \u2014 and produces part of the seminal fluid.<\/p><p> Two anatomical structures are closely linked to the prostate and its surgery:<\/p><ul class=\"upo-checklist upo-checklist--dot\"><li> <strong>The urinary sphincters<\/strong> control continence. Preserving them is essential to avoid urinary leakage after surgery.<\/li><li> <strong>The neurovascular bundles (or erectile tissues)<\/strong> \u2014 located on either side of the prostate, control erectile function. Their preservation, when cancer allows, is one of the major goals of robotic surgery. <\/li><\/ul><figure class=\"upo-figure\"><img src=\"https:\/\/www.dumonceau-urologie.fr\/wp-content\/uploads\/2026\/08\/preservation-nerveuse-nerve-sparing-anatomie-prostate.webp\" alt=\"Anatomical diagram: prostate, bladder, rectum and neurovascular bundles in surgical view\" width=\"1200\" height=\"675\" loading=\"lazy\" decoding=\"async\"\/><figcaption> The prostate, bladder and rectum. The vessels and neurovascular bundles run in immediate contact with the gland \u2014 hence the importance of extremely fine dissection.<\/figcaption><\/figure><h3> When does prostate cancer require surgery?<\/h3><p> Not all prostate cancers require a prostatectomy. The decision depends on several factors that we will assess together during your consultation:<\/p><ul class=\"upo-checklist upo-checklist--dot\"><li> <strong>Cancer stage<\/strong> \u2014 T1, T2 = localized; T3 = locally advanced.<\/li><li> <strong>The Gleason score \/ ISUP Grade<\/strong> \u2014 it measures the aggressiveness of tumor cells.<\/li><li> <strong>The PSA level and its kinetics.<\/strong><\/li><li> <strong>Age and life expectancy<\/strong> \u2014 surgery is generally offered to patients whose life expectancy exceeds 10 years.<\/li><li> <strong>General health status<\/strong> and contraindications to general anesthesia.<\/li><li> <strong>The patient&#8217;s preferences<\/strong> \u2014 particularly with regard to potential side effects and quality of life.<\/li><\/ul><div class=\"upo-callout upo-callout--warn\"><p> For very low-risk cancers, <a href=\"https:\/\/www.dumonceau-urologie.fr\/en\/urologue-expertise\/prostate-surveillance-after-age-50\/\">active surveillance<\/a> is preferable to immediate treatment. This is an approach I regularly adopt, and one I often find underestimated: <strong>not operating when it is not necessary is also a courageous medical decision.<\/strong><\/p><\/div><h2 id=\"pourquoi-robot\"> Why robotic surgery? What the Da Vinci Xi really changes?<\/h2><h3> What the human eye cannot do alone<\/h3><p> I have been performing prostatectomies for over 20 years. The difference between the open surgery I learned and the robotic surgery I practice today is fundamental \u2014 not because the robot operates in my place, but because it gives me capabilities that conventional surgery cannot offer. <\/p><figure class=\"upo-figure\"><img src=\"https:\/\/www.dumonceau-urologie.fr\/wp-content\/uploads\/2026\/08\/dr-dumonceau-console-chirurgie-robotique-da-vinci.webp\" alt=\"Dr. Dumonceau at the console of the Da Vinci Xi surgical robot, high-definition 3D vision\" width=\"1200\" height=\"675\" loading=\"lazy\" decoding=\"async\"\/><figcaption> At the console: high-definition 3D vision with high magnification, 360\u00b0 articulated instruments. The robot makes no surgical decisions \u2014 the surgeon operates.<\/figcaption><\/figure><p> What this changes in practical terms:<\/p><ul class=\"upo-checklist upo-checklist--yes\"><li> <strong>Magnifying HD 3D vision<\/strong> \u2014 I see anatomical structures with a precision impossible in open surgery.<\/li><li> <strong>Ultra-thin and articulated instruments<\/strong> \u2014 they allow for extremely fine dissection, particularly of sphincters and neurovascular bundles.<\/li><li> <strong>Shaking eliminated<\/strong> \u2014 the robot filters out micromovements of the hand, making the gesture extremely stable.<\/li><li> <strong>Minimal incisions<\/strong> \u2014 5 incisions of 5 to 12 mm, instead of one large abdominal incision.<\/li><li> <strong>Reduced blood loss<\/strong> \u2014 less than 200 ml on average; transfusion has become extremely rare. <\/li><\/ul><figure class=\"upo-figure\"><img src=\"https:\/\/www.dumonceau-urologie.fr\/wp-content\/uploads\/2026\/08\/bras-articules-robot-da-vinci-xi-bloc-operatoire.webp\" alt=\"Articulated arms of the Da Vinci Xi surgical robot in the operating room\" width=\"1200\" height=\"675\" loading=\"lazy\" decoding=\"async\"\/><figcaption> The Da Vinci Xi&#8217;s articulated arms. The instruments have 360\u00b0 of freedom of movement \u2014 far beyond what the human wrist allows.<\/figcaption><\/figure><h2 id=\"ambulatoire\"> Outpatient care since 2016: a first in France<\/h2><p> In 2016, our team performed the <strong>first outpatient robotic prostatectomy in France<\/strong> . This was not a technical feat for the sake of the feat \u2014 it was a demonstration that with robotics and a rigorous enhanced recovery protocol, some patients can return home on the same day as their prostatectomy.<\/p><p> Today, depending on the case, patients are discharged either on the day of the procedure or the following day. This is a tangible improvement in their comfort and proof that well-conducted minimally invasive surgery truly reduces the impact on daily life.<\/p><p> Robotics simplifies surgery, shortens operating times, reduces the risk of bleeding and postoperative complications, and decreases hospital stays. All of this means less stress for the patient\u2014and a faster start to recovery.<\/p><h2 id=\"deroulement\"> How is robot-assisted prostatectomy performed?<\/h2><h3> Before the procedure: the pre-operative assessment<\/h3><p> A radical prostatectomy is not something to be undertaken lightly. Before the procedure, a complete assessment is carried out:<\/p><ul class=\"upo-checklist upo-checklist--dot\"><li> <strong>Multiparametric MRI of the prostate<\/strong> \u2014 to accurately assess the local extent of the tumor and guide the surgical strategy.<\/li><li> <strong>Discussion in a Multidisciplinary Consultation Meeting (RCP)<\/strong> \u2014 to validate the therapeutic decision with the entire oncology team.<\/li><li> <strong>Complete biological assessment.<\/strong><\/li><li> <strong>Anesthesia consultation.<\/strong><\/li><\/ul><p> To learn everything about the preparation, also consult my dedicated article: <a href=\"https:\/\/www.dumonceau-urologie.fr\/en\/urology\/robotic-prostatectomy-how-to-prepare-properly\/\">Robotic prostatectomy: how to prepare properly<\/a> .<\/p><h3> The day of the operation: the five steps<\/h3><p> The procedure takes place under general anesthesia, in an operating room equipped with the Da Vinci Xi robot. Here are the steps I perform:<\/p><ol class=\"upo-steps\"><li> <strong>Patient and robot setup:<\/strong> Trendelenburg position (patient slightly inclined head down) to clear the pelvic cavity.<\/li><li> <strong>Minimally invasive incisions:<\/strong> 5 incisions of 5 to 12 mm in the abdomen, to introduce the instruments and the 3D camera.<\/li><li> <strong>Robot-assisted dissection.<\/strong> Removal of the prostate and seminal vesicles, with preservation of the neurovascular bundles if the anatomy and tumor stage allow it.<\/li><li> <strong>Vesicourethral anastomosis:<\/strong> Reconnection of the bladder to the urethra after removal of the prostate, restoring urinary continuity.<\/li><li> <strong>Insertion of a urinary catheter<\/strong> for 7 to 10 days, to allow the anastomosis to heal completely.<\/li><\/ol><ul class=\"upo-facts\"><li> <span class=\"upo-facts__label\">Duration:<\/span> <span class=\"upo-facts__value\">2 to 2.5 hours<\/span><\/li><li> <span class=\"upo-facts__value\">General<\/span> <span class=\"upo-facts__label\">anesthesia<\/span><\/li><li> <span class=\"upo-facts__label\">Hospitalization<\/span> <span class=\"upo-facts__value\">for 1 to 2 days (sometimes outpatient on day 0)<\/span><\/li><li> <span class=\"upo-facts__value\">7-day home<\/span> <span class=\"upo-facts__label\">urinary catheter<\/span><\/li><li> <span class=\"upo-facts__label\">Work stoppage of<\/span> <span class=\"upo-facts__value\">4 to 6 weeks<\/span> <\/li><\/ul><figure class=\"upo-figure\"><img src=\"https:\/\/www.dumonceau-urologie.fr\/wp-content\/uploads\/2026\/08\/equipe-chirurgicale-bloc-operatoire-prostatectomie-robotique.webp\" alt=\"Surgical team in the operating room during a robot-assisted prostatectomy\" width=\"1200\" height=\"675\" loading=\"lazy\" decoding=\"async\"\/><figcaption> A robotic prostatectomy requires an entire team: surgeon at the console, surgical assistant in the field, instrument technician and anesthetist.<\/figcaption><\/figure><h2 id=\"nerve-sparing\"> Nerve preservation: the <em>nerve-sparing<\/em> technique<\/h2><p> This is one of the most important aspects of surgery, and one of the most frequently discussed in consultation: <strong>can erections be preserved?<\/strong><\/p><p> The answer is: it depends. Preservation of the neurovascular bundles is possible when the cancer is localized and the surgical margins allow it. When feasible, it significantly improves the chances of <a href=\"https:\/\/www.dumonceau-urologie.fr\/en\/urology\/how-can-i-preserve-my-erections-after-a-prostatectomy\/\">erectile recovery<\/a> after the operation.<\/p><div class=\"upo-callout upo-callout--warn\"> <span class=\"upo-callout__title\">The priority remains oncological effectiveness<\/span><p> If the cancer is in contact with a nerve bundle, <strong>I sacrifice it<\/strong> . There&#8217;s no question of compromising surgical margins in the name of preserving erectile function. It&#8217;s a decision I always explain clearly before the operation, and it&#8217;s made taking into account the MRI and biopsies.<\/p><\/div><h2 id=\"recuperation\"> Recovery: from discharge to long-term follow-up<\/h2><p> This is often what worries patients most\u2014sometimes even more than the operation itself. I understand this concern and I take it seriously. Here&#8217;s what I explain to each of my patients. <\/p><div class=\"upo-table-wrap\"><table class=\"upo-table upo-table--stack\"><caption class=\"upo-table__caption\"> The recovery process after a robotic prostatectomy<\/caption><thead><tr><th scope=\"col\"> Period<\/th><th scope=\"col\"> What&#8217;s happening<\/th><th scope=\"col\"> Instructions and follow-up<\/th><\/tr><\/thead><tbody><tr><th scope=\"row\"> Day 0 \u2013 Day 1<\/th><td data-label=\"Ce qui se passe\"> Waking up in the recovery room, urinary catheter in place, minimal pain<\/td><td data-label=\"Suivi\"> Assisted mobilization from day 0, appropriate pain medication, room monitoring<\/td><\/tr><tr><th scope=\"row\"> Day 1 \u2013 Day 2<\/th><td data-label=\"Ce qui se passe\"> Usual discharge if recovery is satisfactory (sometimes outpatient on day 0)<\/td><td data-label=\"Suivi\"> Home probe, hygiene instructions, emergency number provided<\/td><\/tr><tr><th scope=\"row\"> J7<\/th><td data-label=\"Ce qui se passe\"> Removal of the urinary catheter during a consultation<\/td><td data-label=\"Suivi\"> Monitoring of immediate post-operative recovery<\/td><\/tr><tr><th scope=\"row\"> 6 weeks<\/th><td data-label=\"Ce qui se passe\"> Gradual resumption of light activities; urinary incontinence still possible (approximately 20% of patients)<\/td><td data-label=\"Suivi\"> Follow-up consultation, PSA test, histological results, prescription of physiotherapy and pro-erectile treatments if necessary<\/td><\/tr><tr><th scope=\"row\"> 6 months<\/th><td data-label=\"Ce qui se passe\"> Start of regular follow-up consultations<\/td><td data-label=\"Suivi\"> Clinical examination, PSA monitoring, assessment of urinary and erectile function<\/td><\/tr><tr><th scope=\"row\"> Every 6 months for 15 years<\/th><td data-label=\"Ce qui se passe\"> Follow-up consultations<\/td><td data-label=\"Suivi\"> Clinical examination, PSA testing<\/td><\/tr><\/tbody><\/table><\/div><h3> Perineal rehabilitation<\/h3><p> It is only necessary for patients whose urinary incontinence persists <strong>6 weeks after the procedure<\/strong> . It is carried out by a physiotherapist specializing in this practice and is accompanied by regular exercises at home.<\/p><h3> Erectile recovery<\/h3><p> Erectile recovery after prostatectomy takes longer than the recovery of continence. This is a fact I frankly explain to every patient, because unrealistic expectations cause unnecessary suffering.<\/p><p> Even when the nerve bundles have been preserved, the erectile nerves have been manipulated, and they can take time to recover. This period varies from a few months to two years, depending on the patient. During this time, I recommend <strong>early erectile rehabilitation<\/strong> : PDE5 inhibitors (Viagra, Cialis, etc.), vacuum pump therapy, and in some cases, intracavernosal injections to maintain oxygenation of the cavernous tissue and accelerate nerve recovery.<\/p><p> In cases where erectile function remains insufficient after 18 to 24 months, other options can be considered, including the implantation of a <strong>hydraulic penile implant<\/strong> . This is a discussion I regularly have with my patients, and it doesn&#8217;t represent a failure but rather a further step in their overall treatment.<\/p><h2 id=\"risques\"> The risks of prostatectomy: complete information<\/h2><p> No surgery is without risk. What I must do \u2014 and what I intend to do \u2014 is explain them to you clearly, without minimizing them, and tell you what I am putting in place to reduce them. <\/p><div class=\"upo-table-wrap\"><table class=\"upo-table upo-table--stack\"><caption class=\"upo-table__caption\"> Possible complications and prevention measures<\/caption><thead><tr><th scope=\"col\"> Complication \/ effect<\/th><th scope=\"col\"> Estimated frequency<\/th><th scope=\"col\"> What I am putting in place<\/th><\/tr><\/thead><tbody><tr><th scope=\"row\"> Urinary leakage (transient incontinence)<\/th><td data-label=\"Fr\u00e9quence\"> Frequent in the immediate postoperative period<\/td><td data-label=\"Pr\u00e9vention\"> Perineal rehabilitation from 6 weeks onwards by a specialist physiotherapist if necessary<\/td><\/tr><tr><th scope=\"row\"> Post-operative erectile dysfunction<\/th><td data-label=\"Fr\u00e9quence\"> Variable depending on the possibility of nerve preservation<\/td><td data-label=\"Pr\u00e9vention\"> Nerve-sparing if possible, early erectile rehabilitation<\/td><\/tr><tr><th scope=\"row\"> Positive surgical margins<\/th><td data-label=\"Fr\u00e9quence\"> 5 to 15% depending on the stage<\/td><td data-label=\"Pr\u00e9vention\"> Close PSA monitoring, additional treatment if necessary<\/td><\/tr><tr><th scope=\"row\"> Intraoperative bleeding<\/th><td data-label=\"Fr\u00e9quence\"> Very rare with robotics (< 200 ml on average)<\/td><td data-label=\"Pr\u00e9vention\"> 3D HD vision, precise robot-assisted hemostasis<\/td><\/tr><tr><th scope=\"row\"> Anastomotic complications<\/th><td data-label=\"Fr\u00e9quence\"> Rare (< 2%)<\/td><td data-label=\"Pr\u00e9vention\"> Proven technique, anastomosis control<\/td><\/tr><tr><th scope=\"row\"> Anastomosis stenosis<\/th><td data-label=\"Fr\u00e9quence\"> Rare (1 to 2%)<\/td><td data-label=\"Pr\u00e9vention\"> Endoscopic monitoring if clinical signs are present<\/td><\/tr><tr><th scope=\"row\"> Thromboembolic complications<\/th><td data-label=\"Fr\u00e9quence\"> Weak<\/td><td data-label=\"Pr\u00e9vention\"> Compression stockings, preventive heparin therapy<\/td><\/tr><\/tbody><\/table><\/div><blockquote class=\"upo-quote\"><p> Informed consent is a crucial moment in our relationship. I take the time necessary to ensure you understand exactly what you are agreeing to, and what we will do together to achieve the best possible outcome.<\/p> <cite>Dr. Olivier Dumonceau<\/cite><\/blockquote><h2 id=\"indications\"> For whom is robot-assisted radical prostatectomy indicated?<\/h2><h3> The right directions<\/h3><ul class=\"upo-checklist upo-checklist--yes\"><li> <strong>Localized prostate cancer (stages T1\u2013T2)<\/strong> at intermediate or high risk.<\/li><li> <strong>Locally advanced cancer (T3a)<\/strong> in some selected cases, in multidisciplinary discussion.<\/li><li> <strong>Life expectancy greater than 10 years<\/strong> , to fully benefit from the curative treatment.<\/li><li> <strong>Good general condition<\/strong> , compatible with general anesthesia.<\/li><li> Desire for a radical treatment with the best possible preservation of urinary and erectile function.<\/li><\/ul><h3> Cases where I propose a different approach<\/h3><ul class=\"upo-checklist upo-checklist--no\"><li> <strong>Metastatic cancer<\/strong> \u2014 surgery is not indicated; systemic treatment is necessary.<\/li><li> <strong>Very low-risk cancer<\/strong> \u2014 active surveillance may be preferable to any immediate treatment.<\/li><li> <strong>Contraindication to general anesthesia<\/strong> \u2014 radiotherapy will be discussed.<\/li><li> <strong>Life expectancy less than 10 years<\/strong> \u2014 the benefit\/risk ratio may not be favorable.<\/li><li> <strong>Refusal of potential side effects<\/strong> \u2014 depending on the patient&#8217;s priorities, another option may be preferable.<\/li><\/ul><p> My role is to present you <strong>with all<\/strong> the options, with their advantages and disadvantages, and to help you choose the one that best suits your cancer and your life.<\/p><h2 id=\"faq\"> FAQ: Your questions about robotic prostatectomy<\/h2><div class=\"upo-faq\"><details class=\"upo-faq__item\"><summary> How long is the hospital stay after a robotic prostatectomy?<\/summary><div class=\"upo-faq__answer\"><p> Generally, 1 to 2 days. Since 2016, our team has offered outpatient prostatectomy for selected patients (returning home the same day). This was a first in France, initiated by us, and is now practiced in a few leading centers. For most patients, discharge takes place the day after the procedure.<\/p><\/div><\/details><details class=\"upo-faq__item\"><summary> Will we inevitably experience urinary incontinence after the operation?<\/summary><div class=\"upo-faq__answer\"><p> Urinary leakage in the weeks following catheter removal is common. This is expected and temporary for the vast majority of patients. The keys to normal continence are good sphincter control during the procedure and, if necessary, pelvic floor rehabilitation physiotherapy.<\/p><\/div><\/details><details class=\"upo-faq__item\"><summary> Can erections be preserved after surgery?<\/summary><div class=\"upo-faq__answer\"><p> It&#8217;s possible, depending on the case. Nerve-sparing surgery\u2014which preserves the neurovascular bundles responsible for erections\u2014is performed when the cancer allows. When this procedure is carried out, the majority of patients regain satisfactory erections within 6 to 24 months.<\/p><\/div><\/details><details class=\"upo-faq__item\"><summary> Is prostatectomy the only option for localized cancer?<\/summary><div class=\"upo-faq__answer\"><p> No. Active surveillance (for very low-risk cancers), focal therapies (HIFU), external beam radiation therapy, and brachytherapy are valid alternatives depending on the patient&#8217;s profile. Each situation is discussed in a multidisciplinary tumor board meeting, and the final decision always rests with the patient, after receiving complete information on the advantages and disadvantages of each option.<\/p><\/div><\/details><details class=\"upo-faq__item\"><summary> Is it possible to have a prostatectomy performed on an outpatient basis?<\/summary><div class=\"upo-faq__answer\"><p> Yes \u2014 in certain selected cases. Our team was the first in France to perform outpatient robotic prostatectomy in 2016. This option is offered to patients in good general health, without major comorbidities, living within two hours of the clinic, and with a caregiver at home. It is not suitable for everyone, but when possible, it significantly improves patient comfort.<\/p><\/div><\/details><details class=\"upo-faq__item\"><summary> How much does a robotic prostatectomy cost? Is it covered by insurance?<\/summary><div class=\"upo-faq__answer\"><p> Radical prostatectomy for prostate cancer is covered by French National Health Insurance (Assurance Maladie) as part of the coordinated care pathway. If the procedure is performed in the private sector, the remaining cost for additional fees will depend on your supplemental health insurance (mutuelle). I will refer you to appropriate facilities during your consultation.<\/p><\/div><\/details><details class=\"upo-faq__item\"><summary> How long after the operation should you stop working?<\/summary><div class=\"upo-faq__answer\"><p> For office or sedentary work: generally 4 weeks off work. For physical work: 4 to 6 weeks depending on progress. Driving is possible as soon as you feel comfortable without painkillers and without abdominal discomfort\u2014generally after 2 to 3 weeks. Resuming walking is encouraged from the first week; intense sports should be gradually resumed after 6 weeks.<\/p><\/div><\/details><details class=\"upo-faq__item\"><summary> Is follow-up after surgery important?<\/summary><div class=\"upo-faq__answer\"><p> Essential. PSA levels are measured at 6 weeks, 6 months, and then every 6 months for 15 years. An undetectable PSA level (< 0.07 ng\/mL) after surgery indicates complete surgical success. Any PSA increase must be addressed promptly to assess the need for further treatment (salvage radiotherapy). This is why follow-up is an integral part of the treatment.<\/p><\/div><\/details><details class=\"upo-faq__item\"><summary> What if the cancer recurs after surgery?<\/summary><div class=\"upo-faq__answer\"><p> Prostatectomy has the advantage of leaving other options open in case of recurrence, notably salvage radiotherapy to the prostatic fossa, which can be effective if the recurrence is detected early (PSA < 0.2 ng\/mL). This is one of the advantages of surgery compared to initial radiotherapy: if the latter fails, salvage surgery is much more complex. The choice of initial treatment therefore has implications for future options.<\/p><\/div><\/details><\/div><h2 id=\"retenir\"> Key takeaways<\/h2><div class=\"upo-takeaway\"><p class=\"upo-takeaway__title\"> The essentials in five points<\/p><ul><li> Prostate cancer is not an immediate emergency, but <strong>a decision to be made with rigor and information<\/strong> .<\/li><li> Robot-assisted radical prostatectomy is, in the right profiles, <strong>one of the most effective options<\/strong> for treating localized cancer.<\/li><li> The objective: <strong>cancer control + maximum preservation of continence and erectile function<\/strong> , when possible.<\/li><li> This is not the only option \u2014 nor the right one for everyone. Each decision depends on the cancer, your health status, and your quality of life priorities.<\/li><li> You should not face this diagnosis alone: <strong>you need to understand, decide, and be supported.<\/strong><\/li><\/ul><\/div><p> My role is not to steer you towards surgery. My role is to help you make the right choice, with full knowledge of the facts.<\/p><div class=\"upo-cta\"><p class=\"upo-cta__title\"> Let&#8217;s discuss it together<\/p><p> If you recognize yourself in this situation, let&#8217;s schedule an appointment to review your case and your options.<\/p><p class=\"upo-cta__actions\"> <a class=\"upo-cta__btn\" href=\"https:\/\/www.doctolib.fr\/chirurgien-urologue\/paris\/olivier-dumonceau\/booking\/telehealth-suggestion\" target=\"_blank\" rel=\"noopener\">Make an appointment<\/a> <a class=\"upo-cta__btn upo-cta__btn--ghost\" href=\"https:\/\/www.dumonceau-urologie.fr\/en\/besoins-urologie\/treating-localized-prostate-cancer\/\">to treat localized cancer<\/a><\/p><p class=\"upo-cta__contact\"> <span><a href=\"tel:+33142688330\">01 42 68 83 30<\/a><\/span> <span>82 Bd de Courcelles, Paris <sup>17th<\/sup><\/span> <span><a href=\"mailto:contact@dumonceau-urologie.fr\">contact@dumonceau-urologie.fr<\/a><\/span><\/p><\/div><aside class=\"upo-sources\"><p class=\"upo-sources__title\"> Medical sources and references<\/p><ul><li> EAU Guidelines on Prostate Cancer 2024 \u2014 European Association of Urology.<\/li><li> INCa \u2014 National recommendations for the management of prostate cancer.<\/li><li> French Society of Urology (SFU) \u2014 Recommendations for localized prostate cancer.<\/li><li> Ficarra V et al. \u2014 <em>Systematic review: Robot-assisted laparoscopic radical prostatectomy<\/em> . European Urology, 2009.<\/li><li> Haglind E et al. \u2014 <em>Urinary incontinence and erectile dysfunction after robotic vs open radical prostatectomy<\/em> . European Urology, 2015.<\/li><li> French National Authority for Health (HAS) \u2014 Evaluation of robot-assisted surgery in urology.<\/li><\/ul><p class=\"upo-disclaimer\"> This article is for informational purposes only and does not replace a medical consultation. Only a clinical examination and personalized assessment can establish a diagnosis and propose a treatment plan tailored to your situation.<\/p><\/aside><\/div> <script type=\"application\/ld+json\">{\"@context\":\"https:\/\/schema.org\",\"@type\":\"FAQPage\",\"mainEntity\":[{\"@type\":\"Question\",\"name\":\"Combien de temps dure l'hospitalisation apr\u00e8s une prostatectomie robotique ?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"En g\u00e9n\u00e9ral, 1 \u00e0 2 jours. Depuis 2016, notre \u00e9quipe propose la prostatectomie en ambulatoire pour certains patients s\u00e9lectionn\u00e9s (retour \u00e0 domicile le jour m\u00eame). C'est une premi\u00e8re fran\u00e7aise que nous avons initi\u00e9e et qui est aujourd'hui pratiqu\u00e9e dans quelques centres de r\u00e9f\u00e9rence. Pour la plupart des patients, la sortie se fait le lendemain de l'intervention.\"}},{\"@type\":\"Question\",\"name\":\"Va-t-on forc\u00e9ment avoir des fuites urinaires apr\u00e8s l'op\u00e9ration ?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Des fuites urinaires dans les semaines suivant l'ablation de la sonde sont fr\u00e9quentes. C'est attendu et temporaire pour la grande majorit\u00e9 des patients. Les cl\u00e9s d'une continence normale : une bonne pr\u00e9servation des sphincters pendant l'intervention et, si besoin, de la kin\u00e9sith\u00e9rapie de r\u00e9\u00e9ducation pelvi-p\u00e9rin\u00e9ale.\"}},{\"@type\":\"Question\",\"name\":\"Peut-on pr\u00e9server les \u00e9rections apr\u00e8s la chirurgie ?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"C'est possible, selon les cas. La technique nerve-sparing \u2014 pr\u00e9servation des bandelettes neurovasculaires responsables des \u00e9rections \u2014 est r\u00e9alis\u00e9e quand le cancer le permet. Quand elle est effectu\u00e9e, la majorit\u00e9 des patients r\u00e9cup\u00e8rent des \u00e9rections satisfaisantes sur une p\u00e9riode de 6 \u00e0 24 mois.\"}},{\"@type\":\"Question\",\"name\":\"La prostatectomie est-elle la seule option pour un cancer localis\u00e9 ?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Non. La surveillance active (pour les cancers \u00e0 tr\u00e8s faible risque), les traitements focaux (HIFU), la radioth\u00e9rapie externe et la curieth\u00e9rapie sont des alternatives valables selon le profil du patient. Chaque situation est discut\u00e9e en R\u00e9union de Concertation Pluridisciplinaire, et la d\u00e9cision finale appartient toujours au patient, apr\u00e8s une information compl\u00e8te sur les avantages et inconv\u00e9nients de chaque option.\"}},{\"@type\":\"Question\",\"name\":\"Peut-on \u00eatre op\u00e9r\u00e9 en ambulatoire pour une prostatectomie ?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Oui \u2014 dans certains cas s\u00e9lectionn\u00e9s. Notre \u00e9quipe a \u00e9t\u00e9 la premi\u00e8re en France \u00e0 r\u00e9aliser une prostatectomie robotique ambulatoire, en 2016. Cette option est propos\u00e9e aux patients en bon \u00e9tat g\u00e9n\u00e9ral, sans comorbidit\u00e9s majeures, vivant \u00e0 moins de 2 h de la clinique, et ayant un accompagnant \u00e0 domicile. Elle ne convient pas \u00e0 tous les profils, mais quand elle est possible, elle am\u00e9liore significativement le confort du patient.\"}},{\"@type\":\"Question\",\"name\":\"Combien co\u00fbte une prostatectomie robotique ? Est-ce rembours\u00e9 ?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"La prostatectomie radicale pour cancer de la prostate est prise en charge par l'Assurance Maladie dans le cadre du parcours de soins coordonn\u00e9. En cas de prise en charge dans le secteur priv\u00e9, le reste \u00e0 charge sur les compl\u00e9ments d'honoraires d\u00e9pend de votre mutuelle. Je vous orienterai vers les structures adapt\u00e9es lors de la consultation.\"}},{\"@type\":\"Question\",\"name\":\"Faut-il arr\u00eater de travailler longtemps apr\u00e8s l'op\u00e9ration ?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Pour un travail de bureau ou s\u00e9dentaire : 4 semaines d'arr\u00eat en g\u00e9n\u00e9ral. Pour un travail physique : 4 \u00e0 6 semaines selon l'\u00e9volution. La conduite est possible d\u00e8s que vous \u00eates \u00e0 l'aise sans antalgiques et sans g\u00eane au niveau de l'abdomen \u2014 en g\u00e9n\u00e9ral apr\u00e8s 2 \u00e0 3 semaines. La reprise de la marche est encourag\u00e9e d\u00e8s la premi\u00e8re semaine ; les sports intenses sont \u00e0 reprendre progressivement apr\u00e8s 6 semaines.\"}},{\"@type\":\"Question\",\"name\":\"Le suivi apr\u00e8s la chirurgie est-il important ?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Indispensable. Le PSA est dos\u00e9 \u00e0 6 semaines, 6 mois, puis tous les 6 mois pendant 15 ans. Un PSA ind\u00e9tectable (< 0,07 ng\/mL) apr\u00e8s l'op\u00e9ration est le signe d'une chirurgie compl\u00e8te. Toute r\u00e9ascension du PSA doit \u00eatre prise en charge rapidement pour \u00e9valuer la n\u00e9cessit\u00e9 d'un traitement compl\u00e9mentaire (radioth\u00e9rapie de rattrapage). C'est pour cela que le suivi fait partie int\u00e9grante du traitement.\"}},{\"@type\":\"Question\",\"name\":\"Et si le cancer r\u00e9cidive apr\u00e8s la chirurgie ?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"La prostatectomie a l'avantage de laisser ouvertes d'autres options en cas de r\u00e9cidive, notamment la radioth\u00e9rapie de rattrapage sur la loge prostatique, qui peut \u00eatre efficace si la r\u00e9cidive est d\u00e9tect\u00e9e pr\u00e9cocement (PSA < 0,2 ng\/mL). C'est l'un des avantages de la chirurgie par rapport \u00e0 la radioth\u00e9rapie premi\u00e8re : en cas d'\u00e9chec de cette derni\u00e8re, la chirurgie de rattrapage est beaucoup plus complexe. Le choix du traitement initial a donc des implications sur les options futures.\"}}]}<\/script>\n","protected":false},"excerpt":{"rendered":"<p>Procedure, nerve preservation, week-by-week recovery, risks and alternatives: the Da Vinci robotic prostatectomy explained by Dr. Olivier Dumonceau.<\/p>\n","protected":false},"author":1,"featured_media":4862,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[42],"tags":[35,38,34],"class_list":["post-4920","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-urology","tag-post-operative-care","tag-postoperative","tag-urology"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.dumonceau-urologie.fr\/en\/wp-json\/wp\/v2\/posts\/4920","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.dumonceau-urologie.fr\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.dumonceau-urologie.fr\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.dumonceau-urologie.fr\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.dumonceau-urologie.fr\/en\/wp-json\/wp\/v2\/comments?post=4920"}],"version-history":[{"count":1,"href":"https:\/\/www.dumonceau-urologie.fr\/en\/wp-json\/wp\/v2\/posts\/4920\/revisions"}],"predecessor-version":[{"id":4921,"href":"https:\/\/www.dumonceau-urologie.fr\/en\/wp-json\/wp\/v2\/posts\/4920\/revisions\/4921"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.dumonceau-urologie.fr\/en\/wp-json\/wp\/v2\/media\/4862"}],"wp:attachment":[{"href":"https:\/\/www.dumonceau-urologie.fr\/en\/wp-json\/wp\/v2\/media?parent=4920"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.dumonceau-urologie.fr\/en\/wp-json\/wp\/v2\/categories?post=4920"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.dumonceau-urologie.fr\/en\/wp-json\/wp\/v2\/tags?post=4920"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}