Understanding Clinical Trials & Robotic Surgery For Prostate Cancer
- After being diagnosed with early-stage prostate cancer at 57, James Choate-Deeds chose a clinical trial using the Hugo™ robotic system—now FDA-approved—underwent surgery without needing chemo or radiation, and is now urging men to get screened after what he describes as a “quick” recovery.
- Prostate cancer treatment may include surgery, radiation, and/or hormonal therapy. For patients who need to undergo prostate cancer surgery, to remove the prostate gland, robotically-assisted surgery offers a more precise approach and better recovery time than open surgery, which was utilized more often in the past.
- Robotic prostate surgery, also called robot-assisted radical prostatectomy, uses small instruments controlled by a surgeon from a robotic console.
- This surgical approach helps patients “with a quicker recovery, less blood loss, much improved pain scores,” Dr. Akshay Bhandari, director of robotic surgery at Mount Sinai Medical Center in Miami, tells SurvivorNet.
- Clinical trials, like the one Choate-Deeds joined, give patients a chance to try a treatment before it’s approved by the U.S. Food and Drug Administration (FDA), and that can potentially be life-changing for patients. Despite the great benefits that come from clinical trials, they also come with risks (like potential side effects that are not fully understood yet).
- People interested in participating in clinical trials must first talk with their doctor to see if they would be a good fit. For help finding a clinical trial that’s right for you, try our easy-to use Clinical Trial Finder.
- Discover more on “Men Beating The Odds”—an inspiring series that shares the powerful stories of men overcoming prostate cancer and redefining what it means to survive—here.
Rather than rushing into a decision, he spent months consulting specialists and researching his choices—ultimately deciding to join a clinical trial involving the Hugo™ robotic-assisted surgery system, which is now FDA-approved for urologic surgical procedures.
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After getting multiple opinions and learning more about his treatment options, Choate-Deeds was referred to urologist Dr. James Porter, Chief Medical Officer for Robotic and Digital Technologies at Medtronic, Inc—who informed him he was a good candidate for the clinical trial.

Choate-Deeds, who underwent surgery in December 2022, told People that the choice to take part in the trial “ended up being a really easy decision.”
He recounted, “I was amazed, the recovery time was so quick. I’ve had knee surgery, I had an ACL accident, and that was much, much harder than my cancer surgery was.”
The cancer was successfully removed through surgery alone, eliminating the need for chemotherapy or radiation.
RELATED: SurvivorNet’s Guide To Clinical Trials: What Are They And Are They Right for You?
Before long, Choate-Deeds was back to his normal routine—resuming everyday life. He told People, “There’s nothing I don’t do that I did before, and there’s nothing that has slowed me down.
“I consider myself extremely lucky because I found it early, which made it so that it was easier to treat.”
Expert Prostate Cancer Resources
- Don’t Believe the Hype: Do Your Own Research on Prostate Cancer Treatment
- Dr. William Kevin Kelly’s Guide To Making Prostate Cancer Treatment Decisions
- How Doctors Use Risk Assessing System To Determine Best Prostate Cancer Treatment Approach
- Dr. Shirin Razdan’s Guide To Treatment & Living With Prostate Cancer
- Genetic Testing for Advanced Prostate Cancer Can Help Tailor Treatment
- Key Information For Patients Evaluating Prostate Cancer Treatment Options: Stage & Type Matter
- Making Sense Of Risk: A Critical Step In Prostate Cancer Treatment Planning
Now Choate-Deeds continues to encourage other men to check their PSA levels and “be proactive” when it comes to prostate cancer.
It’s great to hear that the robotic surgery he underwent during the clinical trial has since been approved by the FDA.
Medtronic announced in December 2025 that the U.S. Food and Drug Administration authorized its Hugo™ robotic-assisted surgery system for urologic procedures in the United States.
The approval opened up options for hospitals and surgeons, introducing a flexible platform designed to grow minimally invasive and soft-tissue robotic surgery programs nationwide.
Choate-Deeds’ doctor, Dr. Porter, said in a statement as the news was announced, “The Hugo RAS system represents a new and exciting approach to robotic-assisted surgery.
“We’re excited for surgical teams in the U.S. to experience the differentiated technology and partnership from Medtronic, which supports them at every stage of their robotic surgical journey.”
It’s important to note that assisted surgery has been a game-changer in prostate cancer treatment. Dr. Akshay Bhandari, director of robotic surgery at Mount Sinai Medical Center in Miami, previously told SurvivorNet that these days, it’s rare for prostate cancer patients to undergo open surgery.
Robotically-assisted surgery offers a more precise approach and better recovery time.
“There was a time where open surgery was the gold standard for surgical management of prostate cancer, but it did carry the morbidity of a big incision, significant blood loss, increased hospital stay, and increased pain,” he explained.
“Ever since the evolution of robotic surgery and the widespread availability of the surgical robot, we essentially now manage all surgical cases with the robot.”
Plus, for most men with localized prostate cancer, robotic surgery offers excellent long-term outcomes.
What Is Robotic Prostate Surgery?
Though surgery to remove the prostate gland can be done via open surgery, a minimally-invasive laparoscopic or robotic approach is often utilized. In open surgery, the operation is conducted through a larger incision, whereas minimally invasive surgery is done with specialized instruments through multiple smaller incisions.
Robotic prostate surgery, also called robot-assisted radical prostatectomy, uses small instruments controlled by a surgeon from a robotic console. Despite the name, there’s no autonomous robot — it’s your surgeon’s hands at work, just with more dexterity and control.
The robot allows surgeons to operate through small keyhole incisions with a 3D camera that magnifies the field 10 times. That precision is especially important when operating near delicate structures like the nerves responsible for erections and continence.
Robotic surgery helps patients “with a quicker recovery, less blood loss, much improved pain scores,” Dr. Bhandari explains. “Patients are usually able to go home the day or the next day after surgery.”
However, not everyone with prostate cancer needs surgery. For those who do, typically men with localized disease, robotic surgery is often preferred over traditional open surgery.
You might be eligible if:
- Your cancer is confined to the prostate (stages I and II)
- You are healthy enough to undergo surgery (e.g., you don’t have severe heart failure or recent stroke)
- You want a definitive treatment with curative intent
Preparing For Prostate Cancer Surgery: Before, During & After
Radical prostatectomy, or the removal of the prostate gland, remains a highly effective and widely used treatment for localized prostate cancer, particularly in younger and healthier men. Understanding what to expect before, during, and after the procedure can help reduce anxiety and improve outcomes.
Dr. Sanjay Razdan, a surgeon at the International Robotic Institute for Prostate Cancer in Florida, tells SurvivorNet that patients shouldn’t expect to be in surgery for much more than an hour — and most patients leave the hospital the next day.
“My average time is about 80 minutes across the board, so that’s an hour and 20 minutes max,” Dr. Razdan says of the assisted surgery he performs. “We are done with the surgery, they go back to the recovery area, then to their room.
“Four hours later, they’re walking around in the hospital. Overnight stay, next morning, they have breakfast and they’re out of the hospital,” he adds.
Preparing For Prostate Cancer Surgery
Many patients worry about surgery side effects such as incontinence (trouble controlling urine) and erectile dysfunction, but rest assured, most patients regain a high quality of life with time and support.
It’s important to maintain open communication with your care team, follow all postoperative instructions, and attend scheduled follow-ups to ensure the best possible recovery and long-term results.
Preparing For Surgery
A radical prostatectomy is a surgical procedure involving the complete removal of the prostate gland, the seminal vesicles, and, in some cases, the nearby pelvic lymph nodes.
This operation is a cornerstone treatment for patients with localized prostate cancer—typically for those who are younger, in good overall health, and diagnosed at an early stage. The goal is to remove all cancerous tissue and, when possible, achieve a cure. This procedure can be done using various surgical techniques, including traditional open surgery, laparoscopic surgery, or robot-assisted laparoscopic surgery (commonly performed with the da Vinci robotic system).
What To Expect From Robotic Prostate Surgery
Preparation for a radical prostatectomy starts weeks before the actual surgery. Your healthcare team will provide detailed instructions, but the general steps typically include:
- Medical Evaluation and Preoperative Testing: Before surgery, you will undergo a series of evaluations to ensure you are fit for the procedure. This may include blood work, an electrocardiogram (EKG) or chest X-ray if you’re over a certain age or have pre-existing medical conditions, a physical examination and consultation with an anesthesiologist, urine tests to rule out infections, and imaging (such as MRI or CT scans) to assess the extent of the cancer.
- Medication Review: You’ll need to inform your doctor about all medications and supplements you’re currently taking. Some medications, particularly blood thinners (e.g., aspirin, warfarin, or clopidogrel), may need to be paused to reduce the risk of bleeding during surgery.
- Bowel Preparation and Fasting: The night before surgery, you may be instructed to undergo bowel preparation — typically a laxative or enema — to clear the bowels and reduce the risk of infection. You’ll also need to avoid eating or drinking for a specific period (usually after midnight) before the surgery.
- Lifestyle Preparation: If you smoke, you will be advised to stop several weeks before surgery, as smoking can impair healing and increase the risk of complications. You may also be encouraged to maintain a healthy diet and engage in regular physical activity to optimize your surgical outcome and recovery.
How Is The Procedure Performed?
Radical prostatectomy can be performed through several surgical approaches.
The most common methods include:
- Open Radical Prostatectomy: This traditional approach involves making an incision in the lower abdomen to access and remove the prostate gland. It is effective but associated with a longer recovery time and more blood loss compared to minimally invasive techniques.
- Laparoscopic Prostatectomy: A laparoscopic approach involves several small incisions in the abdomen through which long instruments and a camera are inserted. The surgeon performs the procedure while viewing the internal structures on a monitor.
- Robot-Assisted Laparoscopic Prostatectomy (RALP): This is the most commonly used method in the United States and other developed countries. The robotic system provides enhanced precision, 3D visualization, and improved ergonomics for the surgeon. Small incisions are made in the abdomen, and robotic instruments are controlled remotely.
During the surgery the prostate gland and seminal vesicles are carefully dissected away from surrounding tissues, including the bladder and rectum. The urethra is reconnected to the bladder, usually over a Foley catheter to allow healing. Pelvic lymph nodes may be removed if there is a higher risk of cancer spread.
How long the surgery takes varies depending on the technique, but Dr. Razdan explains that many patients undergoing robot-assisted surgery are done in less than two hours.
The entire procedure is performed under general anesthesia.
What Factors Go Into Treatment Choices?
For many patients, the differences between treatment options — such as surgery, radiation, or hormone therapy — can be subtle. But those nuances matter, especially when side effects impact daily life.
Dr. James Ryan Mark, a urologic oncologist at Fox Chase, urges patients to weigh the benefits and trade-offs of each treatment option carefully.
“In certain cases, the differences in treatment options can be relatively minor,” Dr. Mark told SurvivorNet in a recent interview.
WATCH: Balancing Treatment and Quality of Life: What Men Should Know About Prostate Cancer Care
One common combination for aggressive prostate cancer is radiation therapy paired with androgen deprivation therapy (ADT), also called hormone therapy, which suppresses testosterone to slow cancer growth. While this approach can significantly improve recurrence rates and survival, it’s not without cost — especially for older patients.
“Adding those treatments to radiation has a big improvement on the recurrence rate of survival,” Dr. Mark explained.
“But not all men sustain that big of an improvement, and particularly if you’re older, taking out your testosterone can really affect your muscle strength and vitality.”
For some, preserving strength and energy may outweigh a modest increase in cancer control.
“As patients are getting elderly, to some, that is more important than maybe a 10% [increase] in their case of prostate cancer control,” he added.
Dr. Mark also cautions against rigid treatment protocols that don’t account for individual needs. He encourages patients to ask their care team questions and explore different types of treatments, specifically inquiring about possible treatment outcomes and the side effects they bring.
“Sometimes, it almost seems dogmatic in the way the treatments are delivered,” he said. “It’s always good to ask what the benefit of each aspect of the treatment is and what can be given in a different way.”
Dr. Vivek Narayan, a medical oncologist at the University of Pennsylvania, is part of a growing movement in oncology that embraces combination therapy as the backbone of metastatic prostate cancer treatment.
This approach pairs traditional hormone therapy (also called androgen deprivation therapy or ADT) with FDA-approved oral agents like abiraterone, enzalutamide, apalutamide, and darolutamide — each designed to disrupt the testosterone-driven growth of cancer cells further.
WATCH: A Message Of Hope For Men Fighting Advanced Prostate Cancer
These therapies not only slow disease progression but also offer patients a chance at living longer, fuller lives — even with an advanced diagnosis.
Dr. Narayan highlighted the progress in advanced prostate cancer care, noting that the disease is increasingly manageable and patients now have greater potential for improved quality of life. Still, patients must be carefully monitored.
“Even with metastatic prostate cancer, it’s not always the cancer that causes the biggest problems. We’ve got to keep an eye on overall health, because that matters just as much.” Dr. Narayan noted.
This shift in perspective is critical — not just for patients, but for caregivers and clinicians alike. It reframes the diagnosis from a terminal sentence to a chronic condition that can be managed with precision and care.
The outlook for prostate cancer care is promising, driven by breakthroughs in treatment and the rise of personalized medicine. Dr. Narayan’s work at Penn Medicine, among other cancer research centers across the country, continues to push the boundaries of what’s possible, offering patients not just treatment but a renewed sense of continued hope.
If You’re Diagnosed With Prostate Cancer, What to Expect for Treatment?
After testing and establishing your risk, your doctor will discuss possible treatment options. These may range from active surveillance to more aggressive options, including surgery and radiation therapy.
WATCH: Coping emotionally after a prostate cancer diagnosis
Surgery is an option for men with any risk group of prostate cancer that hasn’t spread outside of the prostate gland. The type of surgery most often used is called a radical prostatectomy.
During the procedure, the surgeon removes the entire prostate, along with some tissue around it, including the seminal vesicles that release fluid into the semen. Your doctor can perform this through a traditional open procedure with one large or several small incisions, called laparoscopic surgery.
WATCH: Sexual Function Recovery After Prostate Cancer Surgery
Surgery side effects may include erectile dysfunction and urinary incontinence. Fortunately, the side effects are usually temporary, and there are ways to help you manage them.
“Erectile function is so sensitive when we’re dealing with prostate cancer because the nerves that are critical for this function wrap around the prostate; they’re just so intimately connected to the prostate that they can be damaged from a surgical removal of the prostate or through radiation treatment,” Dr. Isla Garraway, a staff urologist in the Veterans Administration (VA) Greater Los Angeles Healthcare System, told SurvivorNet.
Doctors often recommend sexual counseling after prostate cancer treatment to help improve sexual function. This approach actively addresses the psychological, emotional, and relationship impacts on sexual health.
Radiation therapy is often done when prostate cancer is caught early and confined to the prostate gland.
What Is a Clinical Trial?
A clinical trial is a research study involving volunteers that looks into using new drugs or therapies. The goal of these studies is to test if new treatments are safe and effective.
Why I’d Choose a Clinical Trial For Myself
Clinical trials can be an option for people with cancer at many points during the treatment process. Your doctor may have spoken with you about possibly enrolling in a trial if you have advanced disease or if there’s a drug that’s currently considered investigational that may work better than the standard for you.
A lot of patients may feel uncomfortable about the thought of participating in a trial, but the trials can provide amazing opportunities for patients. For one thing, they give patients access to a bevy of new drugs that are currently being developed by pharmaceutical companies.
Things to Consider
In the U.S., all new drugs have to go through clinical trials before the FDA will approve them. In addition to being potentially live-saving for patients, these trials are also necessary to advance science and cancer treatments.
However, participating in a trial comes with risks as well, and it’s important to talk to your doctor about this before getting involved in one. Some risks to consider are:
- The risk of harm and/or side effects due to experimental treatments
- Researchers may be unaware of some potential side effects for experimental treatments
- The treatment may not work for you, even if it has worked for others
Still, joining a clinical trial comes with benefits as well. You will be given access to treatments that could be life-saving, but simply haven’t made it through the approval process yet.
If participating in a clinical trial is something you think you may be interested in, the government has a list of trials that are currently ongoing. SurvivorNet also has a tool to help you find trials for your particular disease.
Questions To Ask Your Doctor
- Am I a good candidate for robotic surgery?
- What side effects should I be aware of and how will we manage them?
- How many robotic surgeries have you performed?
- What are the risks unique to my case?
- Will I need further treatment afterward?
Contributing: SurvivorNet Staff
Learn more about SurvivorNet's rigorous medical review process.
