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

Written in association with: Mr Marcus Cumberbatch
Published:
Edited by: Conor Dunworth

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.

By Mr Marcus Cumberbatch
Urology

Mr Marcus Cumberbatch is a leading consultant urological surgeon based in Sheffield and Nottingham, who specialises in prostate cancer, prostate biopsy and bladder problems alongside bladder cancer, benign prostate disease and diagnostic treatment. He privately practises at The Thornbury Hospital, Spire Hospital Claremont and The Park Hospital, while his NHS base is Royal Hallamshire Hospital. He is also the Cancer Lead of the directorate.

Mr Cumberbatch has an impressive educational CV, with an MBBS from University College London and MRCS from the Royal College of Surgeons of England. As part of his medical school training, Mr Cumberbatch attended the Welcome Institute where he obtained a scholarship to complete an Intercalated BSc in the History of Medicine.

Further educational achievements include foundation training in the Nottingham Deanery, the Academic Clinical Fellowship and a PhD in Cancer Biology. He was also awarded an Academic Clinical Lectureship by the National Institute for Health Research (NIHR) and was granted the Ellison-Cliffe Foundation Award by the Royal Society of Medicine (RSM) where he learnt about robot-assisted surgery and novel cancer diagnostics in Melbourne, Australia.   

Mr Cumberbatch is highly respected among his peers, and he has presented at various international conferences in countries including Japan, Spain and Denmark. He holds several leadership positions including principal investigator on a number of NIHR portfolio clinical trials investigating the use of robotics in minimally-invasive surgery, patient outcome meetings and cancer screening.  

His clinical research has featured in a selection of peer-reviewed journals, and he has an international reputation for his cancer epidemiology knowledge. Mr Cumberbatch is a member of various professional organisations, including the European Association of Urology (EAU) and the Medical Defence Union (MDU). Furthermore, he's a fellow of the Royal College of Surgeons of Edinburgh.      
 
In 2021, Mr Cumberbatch published an international multicentre series showing that robotic surgery can be used even in high-risk situations where kidney function is poor or only one kidney is present. These patients previously may have been facing open surgery or lifelong dialysis, but with robotic techniques can now be offered a keyhole operation to remove the cancer with less complications, faster recovery, and preserved kidney function. 

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