Prostate surgery, also known as a radical prostatectomy, is often the only real hope for some 220,000 men diagnosed with prostate cancer each year. Nearly 50% of men develop some form of prostate cancer by the age of 50 and risks continue to increase with age. However, Montefiore Medical Center, one of the first hospitals in the state of New York to establish a laparoscopic prostate cancer program in 2001, is helping the radical prostatectomy become less radical, as it is one of only 300 hospitals nationwide employing the robotic da Vinci Surgical System for the surgical treatment of prostate cancer.
This state-of-the-art four-armed robot, designed to offer the broadest possible base of patients all the benefits of minimally invasive surgery, allows surgeons to direct the micro-movements of small surgical instruments through tiny incisions. While seated at a control panel, surgeons are able to operate the robot's arms and hands, which feature a wrist design that actually has more flexibility and twisting motion than human hands. Hence they are able to operate with more precision through smaller incisions than with traditional/open surgery. Additionally, the robot holds a magnified, 3D camera that enables the surgeon to see everything 10-15 times larger than the naked eye.
For patients, the benefits are clear and plentiful. "Patients experience less blood loss, less pain, a speedier discharge from the hospital, and a more cosmetically-pleasing outcome," Dr. Ghavamian explains. "And because this is a more accurate operation since the visualization is better, we can spare the nerves for erection easier and conduct the reconstructive portion of the procedure after the removal of the prostate more efficiently."
The robot's record compared to traditional/open surgery regarding the preservation of erectile function and urinary continence is also impressive. "The operation has shown to be at least equivalent - and in many cases - better than the standard open surgery," Dr. Ghavamian notes. "Early data suggests that these two functions can return faster with the robotic prostatectomy than with open radical surgery."
Robotic surgery is also applicable to appropriately selected bladder cancer patients. "If a patient needs a resection or radical surgery for removal of the bladder, we usually do it robotically," Dr. Ghavamian adds. "Our ultimate goal is to treat and rid the cancer, while preserving the quality of life or helping the patient to return to his or her quality of life."