Robotic Prostatectomy Minimizes Surgery, Reduces Recovery Time, and Shortens Hospital Stays
Recent Mount Sinai study shows significant benefits to robotically assisted procedures over open prostate surgery.
A new study of almost 700 patients from The Mount Sinai Medical Center shows that prostate cancer patients who had robotically assisted prostatectomy enjoyed significant benefits over patients who had a traditional open radical prostatectomy, including decreased surgical and recovery time, less blood loss during surgery and significantly shorter hospital stays. The study, by David B. Samadi, MD, Chief of the Division of Robotics and Minimally Invasive Surgery at Mount Sinai School of Medicine, will be published later this month on the website of the Journal of the Society of Laparoendoscopic Surgeons (JSLS), and then in print following that.
Comparing 575 patients who had robotic prostatectomy with 106 patients who had open prostatectomy, the robotically assisted procedures were associated with 45 percent shorter median anesthesia time, 51 percent shorter surgical time, and 96 percent less estimated blood loss. Overall hospital stays were also 67 percent shorter in the robotically assisted cases.
In addition, none of the robotic prostatectomy patients required transfusions or intraoperative red cell salvaging. There were also no rectal perforations – a common complication of prostate surgery – or other intraoperative complications in the 575 robotically assisted prostatectomy patients.
All of the robotic procedures in the study were performed by Dr. Samadi. The study was controlled so there was no difference in the baseline demographic data between the two groups.
"The best practice in fighting prostate cancer is not to wait until you have warning signs," said Dr. Samadi. "Some patients may see blood in their semen or urine, or deal with urination problems. When the cancer has spread it can manifest itself in bone and back pain, or compression of the spine. Prostate cancer is also known as the 'silent killer,' because once a patient has symptoms of prostate cancer it can be too late. That is why frequent screenings are a must.
"And what is important to keep in mind is that while prostate cancer is a serious health problem for men, it is not a death sentence," said Dr. Samadi. "With the proper care and treatment, there is life after prostate cancer."
Robotic prostatectomy, also known as Robotic Assisted Laparoscopic Prostatectomy, is a minimally invasive type of prostate cancer surgery that utilizes a laparoscopic surgical robotic unit called the da Vinci system, manufactured by Intuitive Surgical. Also known as bloodless prostate surgery, this revolutionary and advanced prostate cancer surgery profoundly reduces trauma to surrounding tissue and the familiar unwanted side effects of other treatments. The procedure also provides the lowest risk of incontinence and sexual dysfunction, which sometimes are side effects of prostate cancer surgery.
"Our goal," Dr. Samadi says, "is not just survival, but to improve the patient's quality of life."
During robotic prostatectomy, Dr. Samadi performs the procedure from a console, manipulating the hand controls and viewing the operation live through the da Vinci robot's InSight vision system. Dr. Samadi is able to enter into the patient through a few small "keyhole" incisions and manipulate the surgical tools with small but precise instruments that allow him to handle tissue with greater accuracy and remove the prostate gland without harm to surrounding tissue. After the procedure, the patient is left with only a few small marks on the abdomen, and without the scars that are normally associated with prostate cancer treatment and surgery.
One of the nation's leading urologic oncologists, specializing in robotics and minimally invasive surgery for prostate cancer, Dr. Samadi has treated more than 2,300 prostate cancer patients from around the world. He is one of a few urologic oncologic surgeons in the United States trained in all three primary areas of surgery – open, laparoscopic, and robotic – lending additional weight behind his advocacy for robotic surgery as the surgery of choice for prostate care.
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About The Mount Sinai Medical Center
The Mount Sinai Medical Center encompasses The Mount Sinai Hospital and Mount Sinai School of Medicine. The Mount Sinai Hospital is one of the nation’s oldest, largest and most-respected voluntary hospitals. Founded in 1852, Mount Sinai today is a 1,171-bed tertiary-care teaching facility that is internationally acclaimed for excellence in clinical care. Last year, nearly 60,000 people were treated at Mount Sinai as inpatients, and there were nearly 450,000 outpatient visits to the Medical Center.
Mount Sinai School of Medicine is internationally recognized as a leader in groundbreaking clinical and basic science research, as well as having an innovative approach to medical education. With a faculty of more than 3,400 in 38 clinical and basic science departments and centers, Mount Sinai ranks among the top 20 medical schools in receipt of National Institute of Health (NIH) grants. For more information, please visit www.mountsinai.org.