Robot-assisted radical prostatectomy (RARP): A comprehensive guide

Robot-assisted radical prostatectomy (RARP) is the gold-standard surgery for prostate cancer. In his latest article, renowned consultant urological surgeon Mr Marcus Cumberbatch explains what the surgery consists of, when it is required and the risks and recovery time.

What is a robot-assisted radical prostatectomy (RARP)?

A RARP is a procedure done for prostate cancer (PCa). Men who have PCa are often faced with a decision of whether to have radiotherapy or surgery. The gold-standard surgery for PCa is a RARP.

This keyhole technique uses robotic arms that have unique next-generation movement and precision to remove the prostate and the cancer within. The surgeon sits at a console next to the patient and uses 3-D vision telescopes that magnify the view and enable to greatest attention to detail.

When is it required?

When PCa is diagnosed, it is given a risk score using the PSA blood test, MRI magnetic resonance imaging) scan results and biopsy results (Gleason score). RARP can be a suitable option for treating all risk groups of prostate cancer.

How long does it take, and is it safe/painful?

Men can expect the operation to take 2 hours. A morning appointment can expect a same-day discharge, and an afternoon case would normally stay overnight for observation. The procedure is typically very well tolerated. 

What are the associated risks?

The risks/side-effects of a RARP include

• infection (5%)
• bleeding (low risk)
• incontinence (involuntary leakage of pee (5% risk by 6 months after surgery)
• erectile problems (50%, this can be treated using medical or further surgery)
• bowel injury (<1%).

What is recovery time like?

Men will have a catheter for 10 days. Typically, men can drive after 2-3 days and fly after 2 weeks. Most activities (e.g., long walks) are possible after a week or two and can be gradually increased according to energy levels. Patients are advised not to perform heavy lifting for 6 weeks. We invite all men back for a review 6 weeks after surgery for up-to-date

Mr Marcus Cumberbatch is a renowned consultant urological surgeon based in Sheffield and Nottingham. If you would like to book a consultation with Mr Cumberbatch you can do so today via his Top Doctors profile.