MountainView Hospital - January 08, 2019

One in nine men are diagnosed with prostate cancer, resulting in more than 29,000 deaths annually in the United Sates. MountainView Hospital is the only hospital in Las Vegas to offer nerve monitoring during robotic-assisted laparoscopic radical prostatectomies.

The robotic system gives the surgeon more precision and control during the procedure. In addition, a nerve monitoring system is used during a robot-assisted surgery to inform surgeons with useful real-time data and signals to accurately locate and identify major nerves around the prostate.

When prostate cancer develops and advances, a surgical treatment, formally known as prostatectomy, will most often be done to treat localized prostate cancer. It may be done alone, or with radiation, chemotherapy and hormone therapy. A prostatectomy is a procedure performed to remove the prostate, surrounding tissues, and seminal vesicles.

“A prostatectomy can be frightening to many patients,” says Dr. Alex Lesani, MountainView Hospital urologist and robotic surgery privileged surgeon. “There are a lot of nerves and sensitive structures around the prostate. Performing a procedure to remove the prostate comes with potential risks. However, at MountainView Hospital we’re taking steps to do all we can to prevent damage and side effects by being the only hospital in Las Vegas to utilize the nerve monitoring system.”

When performing a prostatectomy, it’s difficult to locate important nerves around the prostate that can be damaged. The first month of recovery is recovering from scarring and weening off the catheter. After the first month is when post prostatectomy side effects can be seen.

Before performing a prostatectomy, doctors will first run tests to try to establish that the cancer has not spread beyond the prostate. Tests may include biopsies, CT scans, MRI scans, bone scans, and ultrasounds.

The traditional approach to doing a prostatectomy is an “open” approach in which the surgeon makes a cut to remove the prostate and nearby tissues. Two main “open” approaches are as follows:

  1. Radical retropubic prostatectomy is the procedure in which the surgeon makes an incision in your lower abdomen from the belly button down to the pubic bone.
  2. Radical perineal prostatectomy is the procedure in which the surgeon makes the incision in the skin between the anus and scrotum. This approach is used less often because it’s more likely to lead to complications and side effects post operation.

Surgeons are now implementing a laparoscopic prostatectomy option that has a few advantages over “open” approaches including less blood loss and pain, shorter hospital stays, and faster recovery times. For a laparoscopic prostatectomy, the surgeon makes several small incisions and uses special instruments to remove the prostate. One of the instruments utilizes a small video camera, enabling the surgeon to see clearly inside the body during the procedure.

“Nerve monitoring stimulates the nerves and provides real-time, accurate feedback that helps me to avoid damaging major nerves around the prostate,” says Dr. Lesani. “This greatly decreases the nerve damage and chances of major side effects post operation.”

There are risks and side effects with any prostate procedure. Two major possible side effects of a prostatectomy are urinary incontinence, not being able to control urine, and erectile dysfunction, problems getting or keeping erections.

“Experiencing urinary incontinence or erectile dysfunction can decrease a patient’s quality of life, and as the surgeon, my goal is to preserve as much of the major nerves and organs,” explains Dr. Lesani. “Nerve monitoring during a robot-assisted prostatectomy is very advantageous to the surgeon and the patient. We’re making a good surgery, better!”

If you or a family member has questions about seeking the right treatment for prostate cancer, visit for more information or call (702) 962-5021 to find a physician you can speak with.