Radical Robotic Laparoscopic Prostatectomy: What I Didn’t Know About Early Recovery

A friend of mine recently had a radical robotic laparoscopic prostatectomy as his treatment choice for prostate cancer. He researched surgeons throughout the United States and traveled quite a distance to have his surgery.

How the surgery went

The surgeon removed his prostate, seminal vesicle, and lymph nodes near the prostate to test for the presence of cancer in those nodes.

The surgery went well. The lymph nodes were clean, his Gleason score was the same as before the surgery, and the doctor felt nerves related to erectile function were spared.

Possible side effects

Like me, my friend was advised about two possible short or long-term side effects of the surgery: urinary incontinence and erectile dysfunction.

But also like me, he wasn’t informed about the immediate discomfort that follows the surgery directly related to the procedure: bloating, abdominal and chest cavity pain, weeping incisions, catheter discomfort.

It was his comments about that discomfort that activated my memory and prompted this article.

How robotic surgery works

Robotic surgery involves five incisions. Four are used for instruments: two on the right side of the navel, one at the navel, and one on the left of the navel. The fifth is for insertion of a drainage tube.

The incisions, sealed by staples in my case, looked like the patterns on scarabs, so that was my name for them: scarab scars. Air is pumped into the abdomen to open more space during the procedure. A catheter is inserted after the procedure and remains in place for the first seven to ten days.

Feeling miserable

My surgery was early in the morning, and I spent the rest of the day and one night in the hospital. Medication kept pain at bay until the next morning. By the time I got home in the early afternoon, “I was miserable,” according to my journal entry for that day.

“Wasn’t expecting the abdominal wounds to be so painful. Slept with the help of Percocet.”

It took a couple of days for the pain around the stapled incisions to settle down. I switched from Percocet to ibuprofen pretty quickly. I don’t like the way strong pain medication makes me feel.

Pushing through pain

My abdominal area was bloated, like I’d swallowed a small inner tube, and I had painful cramps. I had substantial pain in my chest cavity and shoulders from the trapped air.

I also experienced a lot of pain every time the catheter moved, especially when I cleaned it as instructed. It took a long time for that pain to settle down after the cleaning process.

Post-anesthesia constipation was also a problem. Miralax helped after a couple of days.

Be prepared

So my friend and I both suffered fairly severe post-surgery pain for several days after the surgery, days I wouldn’t want to repeat. Eventually, the wounds healed, the bloating and trapped air dissipated, and the catheter was removed.

I don’t know how common our experience is, but neither one of us was prepared for it. Even though we both felt like we had good medical teams involved with our surgery, somehow those issues weren’t addressed.

I share this information for anyone who is contemplating surgery as treatment for prostate cancer. Talk to your team about the immediate impact of radical surgery. Be prepared.