da Vinci Prostate Surgery
Traditionally, radical prostatectomy (removal of the prostate gland) was performed through a large incision in the lower abdomen. Because the incision opens the pelvic cavity, the patient often would experience significant blood loss during the surgery. Moreover, the need for the incision was associated with increased perioperative pain and a longer recovery time.
Minimally invasive da Vinci prostate surgery allows the surgeon to perform essentially the same open prostatectomy without the need for the large incision. The robotic approach, utilizing the da Vinci Surgical System, provides easier access to the patient's internal anatomy through five one-centimeter incisions. The robotic instruments, which are completely controlled by the surgeon, have wrist and hand-like maneuverability, which allows the surgeon to move them like his/her own hands during traditional open surgery. The surgeon, during the minimally invasive robotic prostatectomy, is performing the operation while looking through a viewer that provides him/her with an excellent 3-dimensional visualization and 10-fold magnification.
Dr. Seth Lerner, Director of the Prostate Program at White Plains Hospital, states that ,"with the 3-D magnified view, I am more able to identify precisely, and preserve, the delicate structures that surround the prostate. This includes the sphincter muscles, which are responsible for urinary control, plus nerves and blood vessels, which are responsible for potency during the curative cancer operation. The same principles that I have used for years during standard open nerve-sparing (for the preservation of sexual function) radical prostatectomy are applied to robotic surgery. The da Vinci system is not a replacement for surgical skill and experience, or extensive knowledge and understanding of pelvic anatomy. It is merely another tool such as an advanced scalpel and microscope that I can use to perform radical prostatectomy while maintaining the patient's quality of life."
Potential patient benefits of da Vinci prostate surgery include:
- Reduced or minimal post-operative pain
- Reduced blood loss and thereby reduced transfusion rates
- Shorter hospital stay (many patients are discharged home one day after the procedure)
- Faster recovery period and thereby quicker return to work
- Quicker catheter removal
- Reduced scarring
- Greater surgical precision which, in turn, potentially means more accurate removal of cancer and reduced risk of impotence and incontinence
Although there are not yet long term data with respect to cure rates with the da Vinci prostatectomy, the pathological results are comparable to those with open radical retropubic prostatectomy. As such, one can expect the same excellent long-term cure rates realized with the traditional surgery will be achievable with the da Vinci surgical system.
Meet Seth Lerner, MD, Chief of Urology
For more information about da Vinci robotic prostate surgery at White Plains Hospital, contact Seth Lerner, MD at 914-949-7556.