One of the main treatments for men with prostate cancer, that hasn't spread outside the prostate gland, is surgery to remove all of the prostate gland. This operation is called a radical prostatectomy. It is usually done through a large opening made in the tummy area (abdomen) or in the area between the anus and scrotum (perineum). Operations that involve making a large opening to reach the area being operated on are called open surgery.

With a laparoscopic prostatectomy your surgeon doesn't need to make a large opening but can take out your prostate gland using only 4 or 5 small cuts (about 1cm) in your tummy area (abdomen). The surgeon uses specially designed instruments that can be placed through these small cuts. This type of surgery is also sometimes known as keyhole surgery.

After making the small cuts the surgeon uses carbon dioxide gas to fill (inflate) the abdomen. A tiny video camera gives a magnified view of the prostate gland on a video screen. The prostate gland is cut away from surrounding tissues and placed in a small bag before being removed through one of the cuts in the abdomen.

Most studies have shown that laparoscopic surgery is as successful at treating prostate cancer as open surgery. The National Institute for Clinical Excellence (NICE) say laparoscopic prostatectomies can be offered to men with early prostate cancer provided they are fully informed of the potential risks and benefits. They also say this type of surgery should only be carried out by surgeons with specialised training and experience in the techniques involved. See their website at: http://guidance.nice.org.uk/IPG193/publicinfo/pdf/English

Two of the most common side effects of prostatectomy are problems with control over when to pass urine (urinary incontinence) and inability to have an erection (impotence). There doesn’t seem to be any difference in the number of men who experience these side effects with open prostatectomy or laparoscopic prostatectomy.

Specialists think that the main advantages of laparoscopic surgery may include:

• less blood loss (during the operation gas used to fill the abdomen presses on veins in the pelvis and helps to reduce bleeding)
• less pain
• less time spent in hospital
• a quicker recovery time
• earlier return to normal activities.

There are some risks related to this method of operating. They include:

• heavy bleeding (haemorrhage)
• damage to healthy tissue nearby especially the bowel

These complications are far less common when the operation is carried out by a surgeon with specialist training and experience in laparoscopic techniques.