Robotic prostatectomy is now the gold standard surgical treatment for localised prostate cancer. But the robot does not perform the operation — the surgeon does. And experience makes a measurable, documented difference to your outcome.
If you have been diagnosed with prostate cancer and surgery has been recommended, you are likely researching robotic prostatectomy — the minimally invasive, robot-assisted removal of the prostate gland that has transformed outcomes for thousands of men in the UK each year.
What is less well understood is that the outcomes of robotic prostatectomy vary significantly between surgeons. The technology is enabling, but it is the surgeon’s skill, training, and volume that determine whether you retain urinary continence, preserve sexual function, and achieve clear cancer margins. Here is what you need to know.
What is robotic prostatectomy?
Robotic-assisted radical prostatectomy (RARP) uses a surgical robotic system — most commonly the da Vinci platform — to remove the prostate gland through several small incisions in the abdomen. The surgeon controls the robotic arms from a console, viewing a magnified 3D image of the operative field with far greater precision than is achievable with the human hand alone.
Compared to open surgery, robotic prostatectomy offers:
- Significantly less blood loss and a much lower transfusion rate
- Smaller incisions and reduced post-operative pain
- Shorter hospital stay — typically one to two nights compared to four to seven for open surgery
- Faster return to normal activity
- Superior visualisation of the neurovascular bundles that control continence and erections
Why surgeon experience is the critical variable
The evidence on this is unambiguous. Multiple large studies have demonstrated that surgeons who perform higher volumes of robotic prostatectomies achieve significantly better outcomes across all key metrics:
- Positive surgical margin rates — the likelihood that cancer cells reach the edge of the removed tissue — decrease substantially as surgeon volume increases
- Continence recovery at 12 months is measurably better in high-volume surgeon series
- Erectile function preservation rates are higher when the surgeon has refined nerve-sparing technique through repeated practice
- Complication rates, including anastomotic leaks and readmission rates, fall with experience
The learning curve for robotic prostatectomy is steep — most data suggests that surgeons reach a performance plateau only after 150 to 250 cases. A surgeon performing 20 to 30 cases per year is still on that curve years into their practice. A surgeon performing 80 to 100 cases per year reaches mastery far sooner.
What fellowship training adds
Robotic surgery fellowship training — structured post-consultant subspecialty experience at a dedicated robotic centre — compresses the learning curve significantly. Fellows train under high-volume surgeons, observe advanced techniques, and build case numbers in a supervised environment before operating independently.
A fellowship-trained robotic urologist is not simply a consultant who has attended robotic training courses. They have invested a year or more in structured immersion in the technique — and that investment is reflected in their outcomes.
Questions to ask your robotic surgeon
Before consenting to robotic prostatectomy, ask the surgeon directly:
- How many robotic prostatectomies have you performed in total, and how many each year?
- Do you hold fellowship training in robotic surgery?
- What are your personal 12-month continence and potency preservation rates?
- What is your positive surgical margin rate for tumours of my stage?
- Which hospital do you operate at, and does it have a dedicated robotic surgery programme?
A surgeon of genuine expertise will answer these questions with specific data. Vague reassurances — ‘I have done many of these’ — are not sufficient.
Robotic prostatectomy at Urology Clinics Manchester
Mr Aziz Gulamhusein, Consultant Urological and Robotic Surgeon at Urology Clinics Manchester, holds dedicated fellowship training in robotic-assisted urological surgery and maintains an active, high-volume robotic surgery programme. He is among the most experienced robotic prostate surgeons available to private patients in the UK.
His practice encompasses robotic prostatectomy, robotic partial nephrectomy (kidney-sparing cancer surgery), and other robotic procedures — supported by state-of-the-art facilities and a multidisciplinary team.
To discuss robotic prostatectomy with Mr Gulamhusein or another member of our team, contact us to arrange a consultation. Early assessment means more surgical options and better outcomes.