Dr. CARLO BRAVI
Consultant Urologist and Andrologist
Robotic and Minimally Invasive Urological Surgeon
Robotic Radical Prostatectomy in London
Robotic radical prostatectomy is a minimally invasive operation used to treat prostate cancer by removing the prostate gland and seminal vesicles. In selected cases, nearby lymph nodes may also be removed for analysis. Dr Carlo Bravi offers private robotic prostatectomy in London for selected men diagnosed with prostate cancer.
The procedure is performed through several small abdominal incisions using robotic instruments controlled entirely by the surgeon. The robotic system provides a magnified three-dimensional view and allows precise movement within the pelvis; it does not perform the operation independently.
Dr Carlo Bravi offers private consultations for men considering robotic radical prostatectomy or seeking a second opinion about prostate cancer treatment. Private robotic prostatectomy is performed at The Wellington Hospital in London, while initial consultations, assessment and follow-up can be arranged in either London or Northampton. More infor
What Is a Robotic Radical Prostatectomy?
Robotic prostate cancer surgery in London may be considered for selected men with localised or locally advanced disease. A radical prostatectomy involves removing the entire prostate gland, together with the seminal vesicles. After the prostate has been removed, the bladder is carefully reconnected to the urethra.
The operation is performed under general anaesthetic. Robotic instruments are introduced through small keyhole incisions in the abdomen and remain under the surgeon’s control throughout the procedure.
The principal aim is to remove the cancer while preserving urinary control and, where oncologically safe and technically possible, the nerves involved in erectile function.
What Happens During the Operation?
Several small incisions are made in the abdomen to allow the robotic camera and surgical instruments to be positioned. The surgeon separates the prostate from the bladder and urethra, removes the prostate and seminal vesicles, and then reconnects the bladder to the urethra using fine sutures. A urinary catheter is left in place temporarily while this new connection heals.
Depending on the characteristics of the cancer, pelvic lymph nodes may also be removed and sent for laboratory analysis.
The prostate and any lymph nodes removed during surgery are examined by a specialist pathologist. These results help determine the final stage of the cancer and whether any additional monitoring or treatment may be required.
Risks and Possible Side Effects
Robotic radical prostatectomy is a major operation. Potential risks and consequences include:
-
Temporary or persistent urinary incontinence
-
Erectile dysfunction
-
Bleeding or the need for a blood transfusion
-
Infection
-
Blood clots
-
Urine leakage from the join between the bladder and urethra
-
Narrowing of the bladder neck or urethra
-
Lymph fluid collection if lymph nodes are removed
-
Injury to surrounding structures (e.g. bowel)
-
Complications associated with anaesthesia
-
Positive surgical margins or the need for additional cancer treatment
Further detailed information about the procedure, including potential risks and complications, is available in the BAUS patient information leaflet on robotic-assisted radical prostatectomy.
Your individual risks will be discussed during consultation and before consent for surgery.
Who May Be Suitable for Surgery?
Robotic radical prostatectomy may be considered for men whose prostate cancer is believed to be confined to the prostate or immediate surrounding area and who are fit enough to undergo a major operation.
Suitability depends on the stage and grade of the cancer, PSA level, MRI and biopsy results, age, general health, existing urinary and sexual function, previous surgery and individual priorities.
Surgery is not necessarily the best option for every patient. Some men may be more appropriately managed with active surveillance, radiotherapy, hormone treatment or another treatment strategy.
Potential Benefits of the Robotic Approach
Compared with traditional open surgery, the robotic approach uses smaller abdominal incisions and provides the surgeon with a magnified three-dimensional view of the surgical area and precise control of the instruments.
For selected patients, this may result in reduced blood loss, a shorter hospital stay and an earlier return to normal activities. These potential advantages do not guarantee a particular result. Cancer control, continence and erectile function depend on several individual, tumour-related and surgical factors.
Nerve-Sparing Robotic Prostatectomy
The nerves involved in erectile function run very close to the outer surface of the prostate. Preserving them requires the surgeon to dissect closer to the prostate, creating a careful balance between maintaining erectile function and achieving clear surgical margins. The decision depends on the location and extent of the cancer, MRI and biopsy findings, and what is observed during the operation. Nerve preservation should not compromise cancer control.
When oncologically appropriate, the surgeon may preserve one or both nerve bundles. Even after nerve-sparing surgery, erections may become weaker or absent and can take several months or longer to recover. Some men will require tablets, vacuum devices, injections or other treatments as part of an individual penile rehabilitation programme.
Urinary Control After Surgery
Some patients are continent as soon as the catheter is removed, while others initially experience urinary leakage and recover control gradually over time. Pelvic floor exercises are an important part of preparation and recovery and may be recommended before surgery and restarted after catheter removal.
The time required to regain continence varies according to individual and surgical factors. Although most patients improve progressively, a small proportion may experience longer-term urinary incontinence requiring further assessment or treatment.
If you want to learn more about urinary continence recovery after radical prostatectomy, check out this dedicated article written by Dr Bravi.
Recovery After Robotic Prostatectomy
Most patients remain in hospital for one day, although this may vary according to individual circumstances and the progress of the operation.
A urinary catheter commonly remains in place for around one week while the connection between the bladder and urethra heals. Walking is encouraged during the early recovery period, but strenuous exercise and heavy lifting should be avoided until your surgeon advises that it is safe. Many patients require several weeks before gradually returning to their normal routine. More precise instructions will be provided after surgery, based on the procedure, individual progress and the activities or work you intend to resume.
What Happens After the Operation?
The removed prostate is examined under a microscope. The pathology report provides information about the cancer’s grade, stage and surgical margins. A PSA blood test is usually arranged after surgery and subsequently monitored. PSA is expected to fall to a very low or undetectable level after successful removal of the prostate.
If the pathology or PSA results suggest that cancer may remain or return, further monitoring, radiotherapy, hormone treatment or another treatment may be recommended.
Learn more about PSA monitoring after radical prostatectomy.
Alternatives to Robotic Prostatectomy
Surgery is not the only active treatment available for prostate cancer. Depending on the diagnosis, alternatives may include active surveillance, external beam radiotherapy, brachytherapy, hormone treatment, or another treatment in carefully selected circumstances.
Each option has different implications for cancer control, urinary function, sexual function and quality of life. A balanced discussion of the potential benefits, risks and alternatives is therefore essential before deciding whether surgery is appropriate.
Where Is Private Robotic Prostatectomy Performed?
Private robotic radical prostatectomy is performed by Dr Carlo Bravi at The Wellington Hospital in London (NW8 9LE)
Patients do not necessarily need to travel to London for every appointment. Initial consultations, review of MRI and biopsy results, pre-operative discussions and subsequent follow-up may be arranged in Northampton or London. If surgery is recommended, the operation takes place in London.
As robotic surgical platforms are not currently available within the private healthcare sector in Northamptonshire, patients requiring private robotic surgery travel to London for their operation while receiving much of their assessment and follow-up locally.
Why Consult Dr Carlo Bravi?
Dr Carlo Bravi is a consultant urologist with specialist experience in robotic and minimally invasive urological surgery. He has performed several hundred robotic procedures and currently performs more than 100 robotic urological operations each year, including surgery for prostate and kidney conditions. His practice includes the assessment, surgical planning and postoperative follow-up of patients undergoing robotic radical prostatectomy. If you are considering private robotic prostatectomy in London, arrange a consultation to review your diagnosis and treatment options.
During your consultation, Dr Bravi will review your medical history, biopsy, imaging and other available results. He will explain whether surgery is appropriate, discuss alternative treatments and provide an individual assessment of the potential benefits and risks.
Private consultations and second opinions are available in Northampton and London. Dr Carlo Bravi holds practising privileges at The Wellington Hospital. View his consultant profile on the HCA Healthcare UK website.
If you would prefer, you can use the following form to make contact.
Frequently Asked Questions
Clinical Guidance and Further Information
The following independent resources provide further information about prostate cancer, robotic radical prostatectomy and the available treatment options:
-
British Association of Urological Surgeons (BAUS) – Robotic-assisted radical prostatectomy
-
European Association of Urology – Guidelines on Prostate Cancer
These resources provide general information and do not replace an individual clinical assessment. Treatment recommendations depend on the diagnosis, general health, imaging and biopsy results, and each patient’s personal priorities.