
The Robotic Simple Prostatectomy by Dr. Bevan Thomas
The Robotic-assisted simple prostatectomy (RASP) performed by Dr. Bevan-Thomas is an effective solution for men with significantly enlarged prostates who suffer from BPH issues. This advanced procedure utilizes the DaVinci robotic technology to remove obstructing prostate tissue while minimizing the risk of incontinence and erectile dysfunction. Let’s dig deeper into understanding this approach for men with larger prostates.
The Robotic Simple Prostatectomy: Size matters
Benefits of the Robotic Simple Prostatectomy for BPH
⦁ Patients undergoing robotic simple prostatectomy experience a significantly decreased risk of blood loss and reduced operation time compared to traditional open surgery, contributing to a safer surgical experience. In these cases, the use of a catheter can also improve recovery.
⦁ Preservation of urinary continence and sexual function: This approach offers improved preservation of both urinary continence and sexual function following the catheter procedure, enhancing patients’ overall quality of life. Because only the inner aspect of the prostate is removed, the nerves responsible for erections and the major muscle controlling urinary continence are located away from the surgery and are protected. Read below about the Orange peel analogy to learn more.
⦁ Immediate improvement of urinary flow. Patients routinely require a catheter 5-7 days after the procedure to allow the bladder to heal. Immediately after the catheter removal, most men notice an immediate improvement in their urinary flow.
The Orange analogy
The robotic simple prostatectomy can be compared to the delicate task of scooping out the inner part of an orange while leaving its peel intact. To simplify, the prostate has an inner part and an outer layer similar to an orange. Utilizing the daVinci Robotic surgery platform, Dr. Bevan-Thomas removes the enlarged inner section of the prostate gland, akin to extracting the juicy fruit segments of the orange without damaging its outer skin. This is particularly important because the nerves responsible for erections and the muscle most helpful in preventing urinary leakage are on the outside of the prostate, thus minimizing these complications after this surgery. Keep reading for a more in-depth look at the actual surgery.


Steps for the Robotic-assisted Simple Prostatectomy
Minimized Tissue Damage
⦁ By directly accessing the prostate through the bladder, this technique reduces trauma to critical structures such as nerves, muscles, and blood vessels on the outside of the prostate.
⦁ Minimizing tissue damage can contribute to faster postoperative recovery and reduced risk of complications for patients undergoing robotic simple prostatectomy (RASP).
Bladder Stones
One of the problems with an enlarged prostate is the inability to empty the bladder. Bladder stones often emerge as a complication in men with benign prostatic hyperplasia (BPH) and are even more common in men with larger prostates.
In the context of BPH, bladder stones can intensify urinary symptoms, such as discomfort and increased risk of infections, and exacerbate urinary retention. Addressing bladder stones and the underlying BPH is essential to restore proper urinary function and alleviate symptoms.

Recovery After Robotic Simple Prostatectomy
Recovery Time
While there is a learning curve associated with robotic surgery, institutions offering this surgical procedure have reported positive outcomes within minutes using a camera inside the body to navigate and remove the enlarged prostate capsule in a series of carefully planned steps, making use of a catheter. Because the procedure is done laparoscopically and with the DaVinci robotic platform, men walk around within 24 hours after the surgery.
Pain

Limitations
Potential Short-term Issues
⦁ Blood in the urine (usually only blood-tinged)
⦁ Temporary difficulty urinating. (Very Rare)
⦁ Mild discomfort, which typically resolves over time.
⦁ Draining from the port sites – should heal up spontaneously
⦁ Urinary urgency – the overactive bladder no longer has the prostate blocking its way to freedom, so try to ensure you are urinating every 2 hours during the daytime and refrain from drinking fluid 2 hours before going to bed
Alternative Treatment Options for Enlarged Prostate
Medications and minimally invasive procedures offer alternative treatment options for managing symptoms of an enlarged prostate.
Medications
⦁ Alpha-blockers and 5-alpha reductase inhibitors are commonly prescribed to alleviate symptoms associated with prostate enlargement.
⦁ Alpha-blockers work by relaxing the bladder neck and prostate muscles, improving urine flow, and reducing symptoms such as urinary urgency.
⦁ 5-alpha reductase inhibitors help shrink the prostate gland over time by blocking the production of hormones that cause prostate tissue growth.
Minimally Invasive Procedures: Prostate Size Matters
Considerations

Considerations
Key Factors to Consider
⦁ Severity of urinary symptoms: The degree to which urinary symptoms affect daily life can influence the choice between medication or surgical intervention.
⦁ Overall health condition: Existing medical conditions may impact treatment decisions.
⦁ Bladder Function – Unfortunately, many men leave treatment until it’s too late. If the bladder has become overstretched and no longer functions, no surgery or procedure will help. They are destined to intermittent catheterization, which requires men to place a catheter in their bladder 4-6 times a day because the function is lost. Although not typical, it is a devastating side effect of BPH and yet another reason to get checked if you are having urgency, frequency, and waking up at night to urinate.

Conclusion
In conclusion, the Robotic Simple Prostatectomy offers a minimally invasive and effective solution for individuals suffering from an enlarged prostate with urinary symptoms. The procedure, as outlined in the preceding sections, involves a laparoscopic approach with several keyhole incisions in the abdomen and has a quick recovery time. It is only suitable for patients with larger prostates, so it is paramount that you get an ultrasound or MRI to evaluate the size of your prostate. Dr. Bevan-Thomas routinely performs the prostate ultrasound in his office and, along with a cystoscopy, should have a good idea if this is the best procedure for you and your urinary symptoms .
For those seeking more information on BPH or considering a Robotic Simple Prostatectomy, leave a request below or call Dr. Bevan-Thomas’ office in Arlington, Texas.

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Why Dr. Rich Bevan-Thomas for Robotic Simple Prostatectomy?
Robotic surgery is a skillset and Dr. Rich Bevan-Thomas has been performing robotic surgery since leaving UT Houston and MD Anderson Cancer Center in 2002. He has been perfecting his robotic skills for the last 18 years, and most importantly, he will help you make the decision that is best for your condition and size of your prostate.
Although most men will not require a robotic simple/partial prostatectomy, it is in Dr. B-T’s arsenal, so whether your prostate is the size of a strawberry or the size of a grapefruit, he is willing and able to tackle your prostate issues.
If you haven’t yet met with Dr. Rich Bevan-Thomas, click the button below to make an appointment for a robotic simple prostatectomy in Arlington.
