Treatments

This major surgical procedure involves a general anaesthetic and the removal of the whole prostate gland and seminal vesicles in order to treat cancer. It can be performed with sparing the surrounding nerves responsible for erectile function. However, this should only be performed if the grade and location of the prostate cancer allows it.

The prostatectomy is followed by delicate reconstruction of the bladder to the remaining penile urethra. Our national surgical organisation explains the procedure in detail here.

The impact of the invasive and radical nature of this surgery, is diminished by the benefit of this minimal invasive technique. Robotic technology enhances vision and dexterity compared to a pure laparoscopy approach. The Global Robotic Prostate appreciates that this technology is computer assistance, and the potential to enhance surgery for future patients is through this method. Mr Noël’s commitment to prostatectomy will open future paradigms of computer/robotic guidance, in departments not yet practising this.

Our mission is to provide excellent care but also continuously improve on the outcomes for patients who may have to undergo this radical cancer surgery.

Robotic Aquablation of the Prostate

This novel endoscopic procedure uses a semi-autonomous robot, to surgically plan a water jet or aquabeam system to the prostate gland. This software enabled water jet, will perform based on the surgeon’s plan with a harmonised ultrasound system. The robot system can be over-ruled at any stage of the procedure. Aquablation has recently been approved by NICE in September 2023. It is used to relieve men of their obstructive  symptoms from benign enlargement of prostate glands. At the Global Robotic Prostate, we benefit from the experience Mr Noël, along with the prostate team at Guy’s Hospital, have accrued experience in more than 100 procedures since introducing it.

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This technology has propelled the teaching hospital of Guy’s & St Thomas’ NHS Foundation Trust further in its innovative reputation. This news article mentions, where it helped address the NHS urology surgical waiting list. Additionally, an internationally sought, oversubscribed live demonstration course is run by Mr Noël and colleagues.

Robotic aquablation offers less side effects on ejaculatory function compared to the gold standard of transurethral resection of the prostate. This was shown in a 5 year follow up randomised controlled trial (see article). This specific concern patients face when choosing surgery methods for obstructive prostate glands, can now be addressed with this robotic approach.

Other Benign (Non-Cancerous) Urology Conditions

• Hydrocoele or Epididymal Cysts – swelling of the scrotum requiring repair.

• Phimosis (tight foreskin) – managed with circumcision.

• Testicular pain/lumps – managed medically or with surgery according to the cause.

• Urinary Tract Infections (UTIs) in Men – managed medically or when a result of obstructive prostate tissue, is managed with Transurethral Resection of Prostate or Robotic Aquablation.