Advantages and Disadvantages
Advantages of daVinci Robotic Prostatectomy
Since this is a minimally invasive procedure, there is relatively less pain and faster recovery compared to open surgery. Furthermore, the 3-D imaging and the Endowrist technology makes the surgery more accurate and precise than open or standard non robotic laparoscopic prostate surgery. This results in higher chance for cancer cure, more precise dissection of nerve bundles and preservation of erectile function.
There is also less blood loss and shorter hospital stay. Patients usually stay 1 to 2 days in the hospital, followed by 2-3 weeks of recovery at home before resuming all normal activities. Many patients return to work and sports activities such as running, weight lifting, golf, tennis within two weeks after surgery.
Nerve Sparing Prostatectomy is accomplished with high degree of accuracy. Patients have an excellent chance at maintaining their sexual function, thus avoiding long term impotency. Bladder Neck Sparing techniques can also be used. This allows faster recovery of urinary control. Subsequently, patients regain bladder control very quickly after DVP.
As with open surgery, this technique is highly effective and offers a high chance of cure from prostate cancer. Some urologists would argue that surgery results in the highest chance of cure from prostate cancer. DaVinci Robotic Laparoscopic Prostatectomy (DVP) achieves rapid removal of PSA from blood stream, and provides accurate information on the true stage and grade of the cancer, including the status of lymph node involvement.
The patient will know if he is cancer free within a month after surgery, as opposed to up to two years after radiation. Upon removal of the prostate gland and the cancer, the PSA rapidly drops and reaches an undetectable level within a month. Therefore, the patient can rest assured of his cancer free status very early after surgery.
Because this surgery is minimally invasive, many of the disadvantages associated with open surgery are alleviated. Patients are relatively pain free. There is relatively much less chance of bleeding complications. daVinci Prostatectomy is an excellent surgery for Jehova's Witnesses with prostate cancer. Those who want to avoid the need for transfusion, are excellent candidates for this procedure, since it is associated with minimal blood loss. Furthermore, return of bladder control, resolution of incontinence, and return of erections generally occur rapidly.
Disadvantages of daVinci Robotic Prostatectomy
This procedure is highly technical. Most physicians performing prostate surgery have not been trained in this procedure. Therefore, it is not available at all locations, requiring the patient to travel to an experienced surgeon and robotic surgery center. It is recommended that these procedures be performed by urologic surgeons trained in oncologic surgery with extensive laparoscopic and robotic surgical experience. It is recommended that the surgeon performing robotic laparoscopic prostatectomy have done at least 200 of these procedures. The procedure should be done at centers of excellence, supporting high tech robotic programs. Although adverse effects are rare, they could include incontinence, erectile dysfunction, possible formation of blood clots in the leg veins, and infection.
Dr. Ramin has performed, proctored, and instructed over 800 Robotic Prostatectomy procedures. His rates of success are among the best both in terms of cure and in terms of quality of life (pain, recovery, potency, continence).