Doctors at Kokilaben Dhirubhai Ambani Hospital, Mumbai, have achieved a global milestone by successfully removing a 550-gram benign prostate from a 70-year-old patient using robotic-assisted surgery. This procedure is believed to be the largest prostate gland ever removed robotically worldwide.
Complex Case with Significant Clinical Challenges
The patient had suffered from progressive urinary obstruction and recurrent infections for more than six years. In addition, the case posed high surgical risk due to multiple factors, including advanced age, underlying cardiac conditions, a pacemaker implantation, and the exceptionally large size of the prostate. Consequently, conventional open surgery carried a much higher risk of complications.
Robotic Precision Enables Minimally Invasive Approach
To address these challenges, the surgical team opted for robotic-assisted surgery using the da Vinci Xi surgical system. The procedure was led by Dr. Sanjay Pandey, Director of Urology and Head of Andrology & Reconstructive Urology at the hospital.
Unlike open surgery, the robotic approach avoided a large abdominal incision and minimised tissue disruption. Moreover, the technology provided the precision and stability required to safely operate around critical urinary structures in an extremely high-complexity scenario.
Advanced Technology Overcomes Surgical Limitations
Explaining the clinical decision, Dr. Pandey noted that managing very large prostates through conventional minimally invasive techniques can be technically difficult. He highlighted that the da Vinci Xi system offers magnified three-dimensional vision, wristed instruments, and tremor filtration, allowing surgeons to work accurately in confined spaces.
In this case, laser- or telescope-based procedures were not viable due to a narrow urinary passage. At the same time, open surgery would have required a much larger incision, increasing the risk of bleeding, urethral injury, and prolonged recovery. Therefore, the robotic platform proved critical in limiting blood loss and enabling a safer, faster postoperative recovery. Dr. Pandey also emphasised the importance of timely urological evaluation, as long-standing prostate enlargement may not respond adequately to medical therapy alone.
Step-by-Step Surgical Strategy
As per the press release, during the operation, the surgical team first reduced blood flow to the prostate. They then carefully bisected the gland within the bladder cavity, with each portion weighing approximately 250 grams. The two halves were placed in separate retrieval bags to ensure safe removal.
Despite the unusually large size of the prostate—exceeding half a kilogram—the robotic system enabled the team to complete the surgery in just under three hours (2 hours and 55 minutes). Throughout the procedure, surgeons maintained smooth workflow and precise control, even in this highly demanding case.
Rapid Recovery Brings Relief to Family
Following the surgery, the patient recovered well and resumed his routine activities without complications. His family expressed relief at the successful outcome.
“At his age, we were anxious about such a major intervention,” said the patient’s son, who is also a doctor. “However, robotic-assisted surgery helped him recover quickly with minimal discomfort. We are extremely grateful to Dr. Pandey and his team.”
Expanding Role of Robotics in Indian Urology
As robotic-assisted surgery gains wider adoption in India, it continues to expand treatment options for urology patients. Notably, cases such as this demonstrate how advanced surgical technology is being applied to increasingly complex conditions, reinforcing its growing role in delivering safer, high-quality, and minimally invasive care.