Sexual Health Q&A

What is robotic-assisted laparoscopic prostatectomy (RALP)?

Robotic-assisted laparoscopic prostatectomy (RALP) is a type of surgery often used to treat men with prostate cancer.

To understand RALP, it’s helpful to break down the term into its individual parts:

Prostatectomy is a procedure that involves removing a man’s prostate gland.

Laparoscopic refers to the way the surgery is done. It is sometimes called minimally-invasive surgery. First, the surgeon makes some small incisions. Each incision is usually less than one centimeter long. Next, he or she places thin tubes called trochars into the incisions. A tiny camera is sent through one of the trochars and the image is displayed on a monitor close by. Carbon dioxide is sent through another trochar to expand the surgical area and make it easier to see. The surgeon uses other trochars to maneuver surgical instruments.

Robot-assisted means that a 3- or 4-armed robot, under the surgeon’s control, is actually using the surgical instruments.

In a RALP procedure, the surgeon sits at a console that is connected to the robot by cables. The console’s three-dimensional screen can be magnified so he or she can see every detail of the surgical area. The robot cannot function without the surgeon. If there is a problem with the robot, there is often a spare available at the hospital. Or, the surgeon can finish the surgery either laparoscopically or openly (not laparoscopically).

Why might a man decide to have robotic surgery? There are many advantages:

  • Precision. The robot has flexible wrists and can make careful, slight movements with accuracy.
  • Shorter healing time. The smaller incisions usually take less time to heal. Some patients who have RALP have shorter hospital stays than those who have a traditional prostatectomy.
  • Less pain and bleeding. There might also be less risk of infection.
  • Potential for improved urine control and sexual function more quickly.  Research has shown that men who undergo a RALP procedure recover their urinary continence and erections at better rates than those who have laparoscopic or open procedures.

Robotic surgery is becoming more common, although the technology is expensive and cannot be offered by every hospital.

Not everyone is comfortable with the idea of robotic-assisted surgery, however. Patients should feel free to discuss their concerns with their treatment team.