Prostate Cancer Surgeon Melbourne

Robotic surgery for prostate cancer offers advantages over open surgery, including lower blood loss and blood transfusion rates, less post-operative pain, shorter hospital stay and earlier return to normal activity. 

In addition to performing the standard “anterior” approach to robotic prostatectomy, Phil is one of the only surgeons in Australia to perform the “Retzius sparing” technique. 

This procedure has been shown to preserve early urinary continence in most patients, but is performed in only a small number of centres around the world because of the complexity of the approach. Following surgery with this technique, approximately 80% of patients are free of continence pads within 1 week of catheter removal. Phil will discuss this approach with patients who meet certain clinical requirements prior to surgery.

Robotic and advanced laparoscopic urology

Robotic surgery is a type of laparoscopic (“keyhole”) surgery and has advantages over traditional laparoscopic surgery by virtue of the “wristed” instruments, which allow significantly greater dexterity, as well as the high definition, 3D camera system. As for any other surgical approach, outcomes following robotic surgery depend on the training and skill of the surgeon and are not intrinsic to the robotic platform.

Prostatectomy refers to the surgical removal of the prostate gland. It’s often recommended for patients diagnosed with prostate cancer. This procedure can be performed using various techniques, such as traditional open surgical prostatectomy, or minimally invasive techniques like laparoscopic prostatectomy and the more advanced robotic prostatectomy.

Types of Prostatectomy which Phil specialises in:

  1. Robotic Prostatectomy: This minimally invasive technique is performed through small incisions and uses robotic assistance to enhance precision and reduce recovery time.

  2. Retzius-sparing Prostatectomy: This is a robotic prostatectomy utilising a specialised technique to remove the prostate gland whilst  leaving the bladder in its normal anatomical position. This preserves the “space of Retzius”, resulting in improved urinary continence.

Why should patients consider Robotic Prostatectomy?

Robotic prostatectomy offers several advantages over open prostatectomy:

  • Minimally Invasive: The procedure uses small incisions, resulting in less post-operative pain in comparison to open surgery. This leads to quicker recovery and earlier return to normal activity.
  • Precision: Robotic systems enhance the surgeon’s ability to perform intricate manoeuvres, allowing for greater accuracy in removing the prostate while preserving surrounding tissues and nerves.
  • Less Blood Loss: Robotic techniques result in reduced blood loss during surgery, which decreases the need for blood transfusions. Less than 1% of patients require blood transfusion following robotic prostatectomy
  • Shorter Hospital Stay: Patients typically spend less time in the hospital after robotic surgery, usually going home within a day or two.
  • Faster Recovery: Patients experience a quicker return to normal activities, with less postoperative discomfort and lower rates of complications.
  • Improved Outcomes: Published literature confirms that Retzius sparing robotic prostatectomy leads to earlier return to continence with around 80% of patients free of continence pads within 1 week of surgery. Retzius sparing robotic prostatectomy cannot be performed via the open approach.

Which patients are suitable for the Retzius-sparing radical Prostatectomy technique?

Phil now performs Retzius-sparing radical prostatectomy in all patients, even those with high grade and locally advanced disease. Although early published series indicated higher positive margin rates with this technique, Phil has recently published his own experience with the Retzius sparing technique, which showed no difference in margin rates in comparison to the standard technique. Phil has the highest volume in this technique in Australia and is well beyond the early learning curve.

Choosing the Right Robotic Prostatectomy Surgeon

Selecting a qualified robotic prostatectomy surgeon is crucial for optimal outcomes. Consider the following when making your choice:
  • Experience: Phil has been performing robotic prostatectomy since training in London in this technique from 2010 to 2012. He is one of the highest volume robotic surgeons in Victoria.
  • Outcomes: The outcomes from every case performed by Mr Dundee are recorded prospectively so he can give a detailed account of prostatectomy recovery and expected continence and erectile function outcomes for all patients. These outcomes are specific to operations performed by Mr Dundee.

For patients diagnosed with bladder cancer that requires removal of the bladder, robotic surgery should be considered the optimal approach. Always consult with a healthcare provider to explore the best treatment options available.

Choosing a skilled surgeon is critical for successful outcomes in bladder cancer treatment. Philip Dundee is recognised as a leading expert in robotic surgery, ensuring that patients receive the highest level of care.