Prostate Cancer

Cancer prostate is usually staged starting with a PSA (Prostate-Specific Antigen) blood test or PHI (Prostate Health Index) > MRI prostate > prostate biopsy > scans to confirm metastasis > curative intent/referral to oncologists. A raised PSA does not mean the patient has prostate cancer. It is common for people with BPH or a urinary infection to also have a raised PSA. 


Dr Al-Sameraaii performs the prostate biopsy both under general anaesthesia in theatre and with local anaesthesia in the office. An office biopsy is a great option for patients without private hospital insurance to have a short wait time for their biopsy rather than wait on the public waiting list. 


After a confirmative biopsy, Dr Al-Sameraaii will chat with the patient about their options which may include watchful waiting and curative-intent treatment. 


Dr Al-Sameraaii attends a weekly multidisciplinary team (MDT) meeting with oncologists and radiologists to discuss specific consenting patients’ cases and the best treatment options. 

Treatment for prostate cancer

Laparoscopic Prostatectomy

Robotic-Assisted Radical Prostatectomy (RARP)

Robotic-Assisted Radical Prostatectomy (RARP)

 Locations: Calvary Bruce Private Hospital, Calvary John James Hospital

 

The laparoscopic prostatectomy is done through small incisions where Dr Al-Sameraaii inserts surgical instruments and a camera which he controls with his hands.


Dr Al-Sameraaii will peel off the nerves for erection and continence and remove the prostate. Dr Al-Sameraaii will then reattach the urethra to the bladder neck. 


The patient will generally spend approximately 3 nights in the hospital following the surgery. 


The surgery time is approximately 3 hours. 

Robotic-Assisted Radical Prostatectomy (RARP)

Robotic-Assisted Radical Prostatectomy (RARP)

Robotic-Assisted Radical Prostatectomy (RARP)

Locations: St Vincent’s Private Hospital (Sydney) – Performed by Dr Al-Sameraaii and Dr Raji Kooner


The Da Vinci Robot RARP is relatively straightforward. After the patient is put to sleep by the anaesthetist, tiny incisions are made in the abdomen and instruments are inserted into the ports inside the abdomen. The abdomen is inflated with a gas that is generally a higher pressure than the veins pressure to minimise bleeding. 


We then control the Da Vinci Robot which gives us a 3D like image inside the abdomen and four “arms” inside the abdomen which is similar to having a spare set of hands inside. The robot allows us up to 10x magnification and we can move the cameras inside the abdomen to see around corners. 


Using the robot, we can peel off the nerves for erection and remove the prostate. At the end, we can do an extremely accurate anastomosis between the bladder and urethra to ensure that we have exact opposition which gives fewer complications. 


The procedure generally takes 1.5-2.5 hours. 


The advantages of RARP:


Improved preservation of nerves for erectile function


Improved preservation of nerves for long-term continence results


Reduced hospital stay and a short return to work date


Very low complication rate with decreased blood loss

Open Prostatectomy

Robotic-Assisted Radical Prostatectomy (RARP)

Open Prostatectomy

Locations: Calvary Bruce Private Hospital, Calvary John James Hospital 


An open prostatectomy is done through an incision in your lower abdomen from below your navel to just above your pubic bone. This incision is approximately 9.5cm long. 


Dr Al-Sameraaii will peel off the nerves for erection and continence and remove the prostate. Dr Al-Sameraaii will then reattach the urethra to the bladder neck. 

The open prostatectomy generally has a longer hospital stay and longer recovery time due to the large incision in your abdomen.


The procedure generally takes 3 hours.

After the above-mentioned prostate surgeries, you will be left with a catheter. A few days after your surgery you will have an X-ray cystogram at an imaging company and will see Dr Al-Sameraaii the same day to have the catheter removed.