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what to expect
prostate surgery
Step 1 – Arranging a Consultation
Upon contacting our office, you will be scheduled for a consultation with one of our robotic surgeons. Our consult appointments are designed to provide ample time to ask questions and discuss treatment options. Make sure to specify that a robotic surgery consultation is the reason for your visit, so that our staff may schedule you accordingly.
Step 2 – Your Visit
If you have been diagnosed with prostate cancer, be sure to bring with you a copy of your biopsy report, as well as any laboratory tests (such as your PSA score), and any imaging studies that have been done as part of your work-up. If at all possible, bringing the report of the prostate sonogram done at the time of your biopsy can be very helpful, as well.
After reviewing your health history with you and after performing a complete physical exam, your surgeon may need to perform a sonogram of your prostate. If the report from the sonogram done at the time of your biopsy is not available for review, a sonogram in our office helps your surgeon assess the size and shape of your prostate to better counsel you on the expected outcomes after surgery.
At the time of scheduling your surgery, you will receive detailed instructions on how to prepare for your procedure. Any pre-operative visits that are required prior to surgery (e.g. cardiology clearance) will also be coordinated at this time.
Step 3 – The Operation
On the morning of surgery, you will meet the rest of your OR team, including the anesthesiologist and the operating room staff. You will also have an opportunity to address any last-minute questions with your surgeon.
While you are comfortably under anesthesia, your family will receive regular updates on our progress throughout your surgery. After surgery is completed, they will receive a full report in person from your surgeon. About 1 to 2 hours after surgery, your family will be able to see you in the recovery room.
Most of our patients are discharged on the first day after surgery, with a urinary catheter in place. The nursing staff will instruct you on the care of your catheter before you are discharged. A follow-up visit will be arranged prior to your leaving the hospital.
Step 4 – Immediate Post Operative Care
Your first follow up visit is usually scheduled within 7 to 8 days after surgery to remove the urinary catheter. Each patient will meet with his surgeon at this time to discuss the final pathology report from surgery. This will help guide our long-term follow-up care plan and determine whether additional treatments are required.
The urinary and erectile rehabilitation programs will be set up at your first post-operative visit, as well.
- Urinary rehabilitation begins with a consultation with a specialist in pelvic floor physical therapy. With the aid of focused training and the use of state-of-the art biofeedback techniques, the muscles involved in urinary continence are targeted, and exercises are developed to make recovery after surgery as efficient as possible. A few visits with the physical therapist are usually all that are required–the goal of therapy is to develop techniques that can be applied daily, at home.
- Erectile rehabilitation begins immediately following surgery with the use of one of the class of medications designed for improving erectile dysfunction–phosphodiesterase-5 inhibitors, more commonly known as Viagra, Cialis, or Levitra. By taking advantage of the medication’s properties that increase blood flow to erectile tissue, studies have shown that every-other-night use (off-label) can improve the recovery of erections. After approximately two months of use, patients go back to use the medications on an as-needed basis. In addition to the pharmacological rehabilitation, mechanical rehabilitation with a vacuum erectile device (VED) is begun a month after surgery. Used on a daily basis, the VED enhances blood flow to the erectile tissue, helping speed recovery and preventing scar tissue formation.
Your doctor will go over these rehabilitation programs in detail with you, and your progress along their course will be monitored throughout your recovery.
Step 5 – Long Term Care
Prostate cancer requires a lifetime commitment to follow up care. Further visits will include physical exams, PSA blood tests, and a discussion about your progress with erectile and urinary rehabilitation with your surgeon. The schedule for these visits will be outlined at the time of your first post-operative visit, but may change as your needs change.
kidney surgery
Step 1 – Arranging a Consultation
Upon contacting our office, you will be scheduled for a consultation with one of our robotic surgeons. Our consult appointments are designed to provide ample time to ask questions and discuss treatment options. Make sure to specify that a robotic surgery consultation is the reason for your visit, so that our staff may schedule you accordingly.
Step 2 – Your Visit
If you have been diagnosed with a mass on one of your kidneys, be sure to bring with you a copy of your imaging studies—most radiology centers will provide a copy of your studies on a CD upon request. Any additional testing or blood work that has been done as part of your work-up can be helpful, as well.
After reviewing your health history with you and after performing a complete physical exam, your surgeon will review your imaging studies to determine whether robotic surgery is right for you, and to determine whether all or just part of the kidney needs to be removed.
At the time of scheduling your surgery, you will receive detailed instructions on how to prepare for your procedure. Any pre-operative visits that are required prior to surgery (e.g. cardiology clearance) will also be coordinated at this time.
Step 3 – The Operation
On the morning of surgery, you will meet the rest of your OR team, including the anesthesiologist and the operating room staff. You will also have an opportunity to address any last-minute questions with your surgeon.
While you are comfortably under anesthesia, your family will receive regular updates on our progress throughout your surgery. After surgery is completed, they will receive a report of how things went in person from your surgeon. About 1 to 2 hours after surgery, your family will be able to see you in the recovery room.
Most of our patients are discharged on the first or second day after surgery. You will be given detailed instructions on your post-operative care before discharge. A follow-up visit will be arranged prior to your leaving the hospital.
Step 4 – Immediate Post Operative Care
Your first follow up visit is usually scheduled within 1 to 2 weeks after surgery. Each patient will meet with his or her surgeon at this time to discuss the final pathology report from surgery. This will help guide our long-term follow-up care plan and determine whether additional treatments are required.
Step 5 – Long Term Care
Kidney cancer requires a lifetime commitment to follow up care. Further visits will include physical exams, regular blood tests to monitor kidney function, and periodic imaging studies to monitor for a recurrence of the cancer. The schedule for these visits will be outlined at the time of your first post-operative visit, but may change as your needs change.