Open Radical Prostatectomy — Mr Neil Haldar
Offering both open and robotic prostatectomy
With over 1,000 prostatectomies performed, I offer both robotic and open radical prostatectomy, which allows me to tailor the surgical approach to the individual patient, including men with previous abdominal surgery, adhesions or complex anatomy.
GMC: 3683914 | BUPA Platinum Consultant | MBBS MD FRCS (Eng) FRCS (Urol)
Learn more about prostate cancer diagnosis and treatment.
Open Prostatectomy
Open prostatectomy remains an important and effective treatment for prostate cancer, particularly in men who are not suitable for robotic surgery. While most patients today are treated with robotic prostatectomy, some men have had previous abdominal surgery, extensive adhesions or other factors that make a robotic approach less appropriate or less safe.
As one of the few urological surgeons in the UK who continues to offer both robotic and open prostatectomy, I can tailor the surgical approach to the individual patient. This means that men who may otherwise be told they are not suitable for robotic surgery can still be assessed for curative prostate cancer surgery.
When might open prostatectomy be considered?
Open prostatectomy may be the best option when robotic surgery is not suitable or not advisable. This can include men who have had extensive previous abdominal surgery, significant scar tissue or adhesions, complex anatomy, or other technical or medical factors that make a minimally invasive approach more difficult.
In these situations, open surgery can provide safe and effective access for removal of the prostate while still aiming for excellent cancer control.
Who may benefit from open prostatectomy?
You may benefit from assessment for open prostatectomy if:
- You have been told that robotic prostatectomy may not be possible
- You have had major previous abdominal or pelvic surgery
- You have significant abdominal adhesions or scar tissue
- You have a complex surgical history
- You want a second opinion about whether surgery is still an option
- You want to understand the relative advantages and disadvantages of robotic and open radical prostatectomy.
I regularly see patients who want to know whether surgery can still be offered when a robotic approach may not be suitable.
Offering both robotic and open prostatectomy
Most prostatectomies in the UK are now performed robotically, and for many patients this is the preferred approach. However, open prostatectomy still has an important role in selected cases.
Because I offer both robotic and open prostatectomy, I can advise patients on the most appropriate approach based on their cancer, anatomy, previous operations and overall health. The decision is based on what is safest and most effective for the individual patient, rather than a one-size-fits-all approach.
Read about robot-assisted radical prostatectomy.
Is open prostatectomy still an effective treatment?
Yes. Open prostatectomy remains a highly effective treatment for prostate cancer when performed by an experienced surgeon. The aim is the same as with robotic surgery: complete cancer removal where appropriate, with careful attention to urinary continence, erectile function and recovery.
Both open and robotic techniques are approaches to radical prostatectomy. Cancer characteristics, patient factors, surgical technique and surgeon experience all contribute to the overall treatment decision and outcome.
Read about: my experience as a prostate cancer surgeon
Open prostatectomy vs robotic prostatectomy
Robotic prostatectomy is a minimally invasive operation performed through small incisions using the da Vinci robotic system. It offers advantages such as reduced blood loss, less pain and faster recovery for many patients.
Open prostatectomy is performed through a single lower abdominal incision. Although recovery may be somewhat longer than after robotic surgery, it remains an excellent and important option in selected men, particularly when previous abdominal surgery or complex anatomy makes robotic surgery less suitable.
Both approaches are used with the same goal: effective prostate cancer treatment and the best possible long-term outcome.
Comparison at a glance
| Open Prostatectomy | Robotic Prostatectomy | |
|---|---|---|
| Incision | Single lower abdominal | 5–6 small keyhole |
| Suitable for previous abdominal surgery | Often yes | Often still possible; depends on previous surgery, adhesions and anatomy |
| Recovery time | Usually longer | Typically faster |
| Oncological aim | Complete cancer removal where appropriate | Complete cancer removal where appropriate |
| Availability in UK | Selected centres | Widely available |
| Mr Neil Haldar | ✓ Offered | ✓ Offered |
Second opinions for patients not suitable for robotic surgery
Some men are told that robotic surgery may not be possible because of previous abdominal operations or other technical considerations. In these circumstances, a second opinion can be very valuable.
I provide specialist second opinions for men who want to understand whether open prostatectomy remains an option, and whether surgery can still be offered safely and effectively as part of their prostate cancer treatment.
Frequently asked questions
Who is not suitable for robotic prostatectomy?
Most men who are suitable for radical prostatectomy can be considered for a robotic approach. Previous abdominal surgery alone does not necessarily rule out robotic surgery. However, extensive previous surgery, dense adhesions, complex anatomy, anaesthetic or positioning considerations, and other individual factors can sometimes influence which surgical approach is safest and most appropriate.
Can I still have prostate surgery if I have had previous abdominal surgery?
Yes. Previous abdominal surgery does not automatically prevent either robotic or open radical prostatectomy. The choice depends on the nature and extent of previous surgery, the likelihood of adhesions, your anatomy, your prostate cancer and other individual factors. In selected cases an open approach may be preferable.
Is open prostatectomy as effective as robotic surgery?
Both are established approaches to radical prostatectomy and share the same aim of complete cancer removal where appropriate. The best approach depends on the individual patient and the surgeon’s assessment; robotic surgery generally offers advantages in early recovery and blood loss, while open surgery remains an option in selected circumstances.
Why might open prostatectomy be recommended instead of robotic surgery?
Open prostatectomy may be recommended when robotic surgery is not considered the safest or most practical option, for example because of prior abdominal surgery, adhesions or complex anatomy.
How do I know which type of prostate surgery is right for me?
The right approach depends on your cancer, medical history, previous operations, overall health and personal priorities. A specialist consultation can help determine whether robotic or open prostatectomy is the better option for you.
Does previous abdominal surgery mean I cannot have robotic prostatectomy?
No. Many men who have previously undergone abdominal surgery can still have robot-assisted radical prostatectomy. However, extensive previous surgery or dense adhesions may sometimes make robotic surgery more technically complex, so the safest approach needs to be assessed individually.
Patients seeking an opinion about open prostatectomy may be referred or self-refer from elsewhere in the UK.
If you have been told that robotic prostatectomy may not be possible, or if you would like a second opinion about prostate cancer surgery, I would be pleased to help.
I see private patients from across Buckinghamshire, Berkshire, Oxfordshire, West Hertfordshire and London, and also assess men travelling from elsewhere in the UK for specialist prostate cancer surgical opinions.
Private hospital and clinic locations
I am recognised by all major private health insurers. Please contact your insurer for an authorisation number before your consultation.
Mr Neil Haldar’s experience and qualifications
Experience as a prostate cancer surgeon
