Fachartikel von Dr. med. Mustapha Addali: “Roboterassistierte radikale Zystektomie mit intrakorporaler Harnableitung”

“Roboterassistierte radikale Zystektomie mit intrakorporaler Harnableitung
– Operationstechnik und Modell zur Etablierung”

 

Zum Artikel Urologen.info, Heft 4/ September 2015   >>> Artikel Dr. Addali

 

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Die Blaue Scleife hilft aufzuklären

In Zusammenarbeit mit ONKO TV (www.onko.tv) ist dieser Beitrag über die Operation mit dem da Vinci System entstanden (2011)

Unser Kanal bei YouTube

http://www.youtube.com/user/Prostatazentrum?feature=watch

Operation with da Vinci

How it works.

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Counseling

Prostate cancer is not only a disease of the organ. It also brings significant psychological and social burden for the patients.

Psycho-oncological and nutrition counseling

New power, flexibility and confidence building

The psycho-oncology is the interdisciplinary form of psychotherapy, which deals exactly with this topic. That is why we offer our patients the opportunity to the oncological counseling, before they participate in the follow-up treatment (Rehab). So they learn how to handle the evolved stress situations, thus the best possible treatment outcome can be achieved. Of course we also offer the nutrition counseling before you start the rehabilitation. Furthermore alimentation plays an important role in cancer diseases- like the prevention during the therapy, or in assuring the success of the treatment. Our patients during their stay in our hospital elaborate the best alimentation plan together with our dietitian, Anna Lugt-Widmayer in order to help the regeneration, and to preserve health at home, at work and in the spare time.

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Course of operation

The removal of the prostate with the da Vinci-System takes approximately 2 to 3 hours.  Usually the pure operating time is under 90 minutes.

Clear case for qualified surgeons

Before the actual surgery, the da Vinci-System and the patient should be prepared. After the narcosis we generally make 6 small incisions on the abdominal wall, and later the instruments will be put in through them, and the prostate will be removed. While the surgical team, which consists of an assistant operator and medical staff, take care of the patient and the system, the operator can concentrate on the surgery from the console. As soon as the instruments are in position, the prostate is vacated. The vascular area -the prostate is located between the bladder and the urethra- is clamped and diverted. Then the tissues, which surround the prostate, are pushed down. If the prostate cancer has not spread beyond the prostate capsule yet, the prostate can be peeled out from the tissues. This protects the erection nerves and the bladder neck so it has a positive effect for the healing of the structure (vessels and tissue) of the anastomosis. If the cancer has already attacked a bigger area, over the prostate capsule, we remove the prostate with the surrounding tissue layers. After the removal of the prostate and the appended seminal vesicle, the urethral stump is sutured to the bladder neck. We place a catheter through the urethra to spare this area for six to ten days. Then on the fifth postoperative day we do a leakage test- if there is no leakage, we remove the catheter on the same day. If you are interested, here you can watch a video of the surgery: http://www.youtube.com/user/Prostatazentrum

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Course of Treatment

What can a patient exactly expect in the PZNW? You spend your time at us like this:

One week in the PZNW

The treatment of the prostate cancer roughly takes one week – it means: we do the patient admission on Monday, and we let you go home on the following Monday. The following treatment plan shows you your appointments for this week. Besides the obligatory appointments – such as the surgery, the blood tests and the physiotherapy- there are also offers, what we recommend: social services, psycho-oncological counseling and nutritional counseling.

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