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Prostate Cancer Treatment Robotic Surgery

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About The Da Vinci Robotic System And Assisted Surgery

Robotic surgery for prostate cancer

The da Vinci surgical system is operated by a surgeon, allowing them to successfully perform a complex, yet non-invasive surgical procedure. Through a small incision, the surgeon uses delicate instruments, a magnifying camera and lighting. Since the procedure is performed using a smaller opening, there is a reduced chance of bleeding than with traditional surgery. Comparing the da Vinci robotic system to traditional surgery, much smaller scars result, which may further reduce the risk of an infection because the incisions are smaller. The da Vinci robotic system is also used in gynecologic, head and neck, cardiothoracic medicine, and general surgery.

Robotic surgery was approved by the FDA for prostate cancer treatment in 2001. Initially, there were concerns that this technique of surgery may lead to higher cancer recurrence rates or higher complications. However, many countries that use robotic surgery share their experiences, which contributes to even greater best practices guidelines in support of optimal outcomes. This data reveals conclusively that robotic surgery does not compromise cancer control rates, which are applicable to all risk groups.

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An operation called a radical prostatectomy has long been a mainstay of prostate cancer treatment. Offered most often to men whose cancer has not yet begun to spread, it involves removing the entire prostate gland, and can be performed in different ways. With the traditional open method, surgeons remove the prostate through an 8- to 10-inch incision just below the belly button. Alternatively, surgeons can perform a robot-assisted radical prostatectomy. With this approach, miniaturized robotic instruments are passed through several much smaller incisions in the patients abdomen. Surgeons control these instruments remotely while sitting at a console.

At least 85 percent of all radical prostatectomies in the United States today are performed robotically. But how do those high-tech surgeries compare with the traditional open method?

Most studies show no major differences between the procedures in terms of patient survival or their ability to control prostate cancer over the long term. Robotic prostatectomies ostensibly offer quality-of-life advantages for urinary function and sexual health. However, the supporting evidence comes mostly from doctors reports, insurance claims-based data, or studies too small to generate definitive conclusions.

Now, results from a much larger comparative study provide needed clarity.

Side Effects Of Prostate Surgery

The major possible side effects of radical prostatectomy are urinary incontinence and erectile dysfunction . These side effects can also occur with other forms of prostate cancer treatment.

Urinary incontinence: You may not be able to control your urine or you may have leakage or dribbling. Being incontinent can affect you not only physically but emotionally and socially as well. These are the major types of incontinence:

  • Men with stress incontinence might leak urine when they cough, laugh, sneeze, or exercise. Stress incontinence is the most common type after prostate surgery. It’s usually caused by problems with the valve that keeps urine in the bladder . Prostate cancer treatments can damage this valve or the nerves that keep the valve working.
  • Men with overflow incontinence have trouble emptying their bladder. They take a long time to urinate and have a dribbling stream with little force. Overflow incontinence is usually caused by blockage or narrowing of the bladder outlet by scar tissue.
  • Men with urge incontinencehave a sudden need to urinate. This happens when the bladder becomes too sensitive to stretching as it fills with urine.
  • Rarely after surgery, men lose all ability to control their urine. This is called continuous incontinence.

After surgery for prostate cancer, normal bladder control usually returns within several weeks or months. This recovery usually occurs slowly over time.

There are several options for treating erectile dysfunction:

Also Check: What Happens When A Man Loses His Prostate

What Makes The Robotic Prostatectomy A Superior Prostate Cancer Treatment

The da Vinci robotic prostate cancer surgery system is able to provide superior clinical prostate cancer treatment results when compared to non-robotic traditional and scope-assisted procedures.

This is because the da Vinci systems Surgeon Console is equipped to provide the surgeon with a revolutionary, three-dimensional, multi-level magnification spectrum.

More traditional scope-assisted surgery typically provides a much lower resolution image, and a far more limited field of vision. Furthermore, the da Vinci systems sensitive electronics and one-centimeter diameter surgical arms allow the surgeon to make highly precise movements inside the incision during robotic prostate cancer surgery. This means that the malignant tissue can be removed with efficiency and ease unheard of prior to the era of robotic surgery. This greater precision reduces the likelihood of relapse due to missed cancerous tissue.

The precision of the da Vinci system also allows the prostate surgeon to avoid damaging healthy prostate tissue, which improves clinical results, reduces scar tissue build-up, and contributes to an overall shorter recovery period after robotic prostatectomy.

Ive Heard That Ill Have A Catheter After Surgery For How Long

Robotic Prostate Cancer Surgery

One of the benefits of robotic prostate surgery is that the catheter is removed just seven days after the procedure thats 1-2 weeks faster than with patients that have had their prostates removed with open surgery. Dr. Samadi will remove your catheter during an in-office follow-up procedure using X-ray to ensure proper urethra-bladder connection and healing.

Make sure to read about the other prostate cancer treatment options:

Read Also: What Happens If You Have Your Prostate Removed

When You Might Have A Radical Prostatectomy

Your doctor might recommend a radical prostatectomy if:

  • your cancer hasn’t spread outside the prostate gland. This is localised prostate cancer
  • your cancer has broken through the covering of the prostate and spread to the area just outside the prostate gland. This is locally advanced prostate cancer
  • you are well enough to have this operation

The aim of a radical prostatectomy operation is to cure prostate cancer.

Surgery For Prostate Cancer : Introduction

Radical prostatectomy has been performed as an open surgery for quite some time with good success, however as minimally invasive surgery has evolved, it has become possible to perform radical prostatectomies laparoscopically. Recent leaps in technology with the advent of Intuitive Surgical Inc.’s da Vinci robot have taken radical prostatectomy past laparoscopy to an all new level of success. In the hands of a skilled surgeon like Dr. Ahlering, of UC Irvine Medical in Orange County, this new tool allows the radical prostatectomy to be performed minimally invasively with greater precision and ease to both the patient and the surgeon than ever before.

Recommended Reading: How To Treat Advanced Prostate Cancer

What Is Robot Assisted Surgery

Robotic surgery, or robot-assisted surgery, is an advancement in surgical techniques where a surgeon uses a computerized robotic arm with small tools attached to it to carry out complex surgeries.

Robotic surgical system provides the surgeon a high-definition, magnified , 3-D view of the surgical site.

The surgical instruments are controlled by the surgeon using the console, to direct special surgical instruments which are smaller in size, and more flexible than the human hand.

The robot does not perform the surgery on its own. The movement of the surgeons hand just mimicked by the instruments attached to the robotic arms, while this is completely controlled by the surgeon. Robot assisted surgeries offer precise action that is devoid of hand tremors, enabling the surgeon to perform the most complex procedures with enhanced precision, dexterity and control

What is robotic prostatectomy or Robotic prostate cancer surgery

New Technologies And Research

Robotic Surgery for Prostate Cancer

Beyond the da Vinci robotic surgery system, many more technologies in the pipeline will continue to allow surgeons to deliver increasingly precise prostate cancer care.

Experimental studies and trials are using energy-based technology, such as cryotherapy, laser therapy, and high intensity focused ultrasound , to develop effective treatments that focus only on the affected tissue. Whether robotically or manually driven, energy-based therapies are the new frontier in prostate cancer treatment.

To determine if prostate cancer screening is right for you, first consider the risk factors: age over 50 being of African descent having a family history of prostate cancer or an inherited gene mutation linked to colon, breast, or ovarian cancer.

Falling into one or more of these categories doesnt mean you should be screened immediately, however. Current prostate cancer screening guidelines from the U.S. Preventive Services Task Forcerecommend that:

  • Men age 70 or older should not be routinely screened for prostate cancer.
  • Men age 55 – 69 should discuss the risks and benefits of screening with their doctor and decide together when to begin screening.

When you and your doctor decide to proceed with screening, your well-being will continue to be our highest priority.

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What Are The Side Effects

The most common side effects of surgery are leaking urine and problems with getting or keeping an erection .

Your risk of getting these side effects depends on your overall health and age, how far the cancer has spread in and around the prostate and how likely it is to grow, and your surgeons skill and experience.

Experience Still Matters With Robotic

A surgeon may have to perform well over a thousand robotic-assisted prostate cancer surgeries before becoming fully proficient at the procedure. Previous studies of robotic-assisted prostate surgery have suggested that it doesnt take long for surgeons to learn how to perform the procedure safely.

To assess the number of robotic-assisted prostate surgeries that a surgeon must perform before becoming fully proficient, researchers assessed 3,794 patients who were treated by one of three surgeons.

A key outcome that was considered in the study was the rate of positive surgical margins. A positive surgical margin means that cancer is found at the edge of the tissue that was removed during surgery it may be a sign that not all of the cancer was removed.

  • The rate of positive surgical margins declined as surgeons gained experience. The lowest rates of positive surgical margins came after a surgeon had performed more than 1,600 robotic-assisted prostate surgeries.6

Donât Miss: Dr Samadi Prostate Cancer Center

Recommended Reading: Can Prostate Cancer Make You Feel Tired

Minimal Scarring After Robotic Prostatectomy

The sheer size of the incision needed for a traditional prostatectomy produces significant scarring in the patients lower abdomen. The robotic prostate surgery procedure leaves incisions that heal with little or no visible scarring. In addition to the obvious aesthetic value, minimizing scar tissue on the interior walls of the incision promotes better healing. Excess scar tissue build-up can sometimes interfere with the proper function of the prostate. Although such a complication is rare, its worth considering when exploring prostate cancer treatment options. The precision of robotic prostate surgery offers an inherent solution to this potential difficulty. By minimizing the size of the incision needed to remove cancerous tissue, the risk of scar tissue-related complications is greatly mitigated.

Prostate Cancer Treatment Options

Urology and Prostate Cancer Services And Treatments San Jose

There are several options for treatment of prostate cancer. There is not one best treatment that applies to everybody. Each treatment must be individualized. Heres a list of the options:

Active Surveillance/Observation: Formerly called watchful waiting, which includes more-frequent testing to stay on top of the progress of the disease

Surgical Options:

  • Open Prostatectomy: Traditional surgery to remove the prostate
  • Laparoscopic Prostatectomy: Using special tools through small incisions to remove the prostate
  • Robotic-Assisted Radical Prostatectomy: Combination of laparoscopic tools and precision robotic technology to assist surgeon
  • Cryotherapy: Using the extremely cold temperatures produced by liquid nitrogen or argon gas to eradicate abnormal tissue

Radiation Options:

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The Columbia Robotic Surgery Team

Assistant Professor of Urology, Columbia University Irving Medical Center

Specialties

Herbert and Florence Irving Professor of Urology

Emeritus Chair, Department of Urology

Specialties

John K. Lattimer Professor of Urology

Director, Urologic Oncology, Columbia University Irving Medical Center

Chair, Department of Urology, Columbia University Irving Medical Center

Specialties

Recommended Reading: Stage 3 Prostate Cancer Treatment Options

Prostate Cancer Treated With Robotic Surgical System

Randall Minion, M.D., was helping out a newly hired lab technician when he had his prostate specific antigen tested. When he volunteered his blood sample for training purposes at his private practice, he never dreamed it would lead to the serendipitous early detection and treatment of prostate cancer.

“I was 49, so I was half-joking, but it was an appropriate test to run because I would be turning 50 in a few months,” says Dr. Minion, a family medicine physician in Fort Dodge, Iowa. “When my PSA was elevated, I visited my local urologist, who did a biopsy.” It came back positive for cancer and Minion’s doctor discussed treatment options, which included a new robotic surgery procedure.

A physician himself, Dr. Minion already knew the possible side effects of radical prostatectomy, which include urinary incontinence and impotence. He did extensive research on treatment options. “I chose surgery to avoid the many trips required for radiation therapy,” he says. “It also offered me the best chance for a cure.”

After learning more about robotic surgery and its benefits, Dr. Minion scheduled an appointment at Mayo Clinic, whose urology practice is ranked among the top centers for Urology by U.S. News and World Report. It also has one of the longest and most extensive track records in surgical therapy for prostate cancer in the nation.

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Rise Of Robotic Radical Prostatectomy

Menon et al from the Vattikuti Urology Institute at Henry Ford Hospital in Detroit, Michigan, are responsible for the development and popularization of robotic radical prostatectomy. This technique has been gaining widespread acceptance in the United States and Europe and is increasing in penetration worldwide. Robotic radical prostatectomy offers the advantages of the minimally invasive laparoscopic approach but shortens the learning curve, facilitating and hastening mastery of the procedure.

Although solid basic laparoscopic skills are required for access and assistance, the console surgeon role requires less laparoscopic skill. Therefore, the procedure is accessible to experienced open-procedure surgeons with minimal or no laparoscopic experience. In a published report, Badani et al have performed more than 2700 robotic prostatectomies and have reported a mean operative time of 154 minutes, a mean blood loss of 100 mL, and hospital stays of less than 24 hours in 96.7% of patients.

The following image provides a portion of a minimally invasive radical prostatectomy.

The Benefits Of Robotic Surgery

Prostate cancer treatments Robotic Prostatectomy

MRI technology helps us precisely visualize where the cancer is located and whether it is spreading. Based on this information, as well as a patients age, overall health, and personal preferences, prostate cancer treatment can include:

Surgery is typically the best way to remove the cancer, and MedStar Health continues to lead the Mid-Atlantic region in robotic surgery expertise. Using the da Vinci® surgical robot system, I have performed over 3,000 robotic nerve-sparing radical prostatectomies to treat prostate cancer by removing the entire prostate.

Robotic surgery uses small incisions in the abdomen, through which the surgeon inserts tiny instruments. The robots movements mimic the human wrist but with greater dexterity, and its small camera provides a 3-D, magnified view of the prostate and surrounding tissue. Using a console to guide these instruments with extreme precision, we remove the prostate with minimal disruption to the surrounding healthy nerves and tissue that support normal urination and erection.

  • A faster return to your normal urinary and sexual function
  • Lower risk of surgical site infection
  • Less blood loss
  • Less pain overall

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The Most Complete Non

An average of five years of survival on conventional treatments is a poor result, and at the same time huge side effects are experienced. Cancer is a systemic disease and needs a well-differentiated approach. Thats why Immucura combines the best non-invasive treatments.

Each of these elements has superior survival rates and no unwanted side effects:

  • Cell-based Immunotherapy

Clinically proven results and 5-star patient experience: thats what distinguishes Immucuras treatments.

Best Options For Prostate Surgery: Traditional Versus Robot

A diagnosis of prostate cancer that hasnt spread comes with treatment options such as watchful waiting, hormone therapy, and radiation. But if your doctor recommends prostate removal, you have one very important decision: trust your surgery to human hands or to robotic arms controlled by your surgeon. A study led by researchers at Harvard-affiliated Massachusetts General Hospital and published in the Journal of Clinical Oncology found little difference in the outcomes. Yes, the two are basically the same in outcomes, says Dr. William DeWolf, professor of surgery at Harvard Medical School and urologist-in-chief at Beth Israel Deaconess Medical Center. I dont see any difference between the two, nor should there be, based on technique.

Surgeries and outcomes

Researchers looked at the two most common methods of radical prostatectomy . During robot-assisted radical prostatectomy, the surgeon sits at a console and controls robotic arms that have long, thin, laparoscopic-type instruments. Small keyhole incisions are made across the abdomen, and the prostate is removed in its entirety. The surgery typically lasts about four hours.

In contrast, during traditional open radical prostatectomy, the surgeon holds the instruments in his or her own hands, makes a four-inch incision in the abdomen, and then removes the prostate. It lasts about two hours.

Which is right for you

And when it comes to finding a surgeon, Dr. DeWolf recommends asking about expertise, not methodology.

Read Also: What Percent Of Prostate Cancers Are Aggressive

* Urinary Continence After Robotic

Robotic prostatectomy sets an excellent record of continence. Using the definition of zero pads used per day means men will use no pads, not even security pad, although they may have a few drops of leakage during the day. The percentage of men at this zero pad/day standard is 50% at 1 month, and 75% at 3 months after surgery. The remaining men use either a security pad or some number of pads per day at 3 months.

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