Robots in the O.R. Help Perform Prostate Cancer Surgery
- Gerald A. Anzalone, D.C., October 8, 2004

Until recently, men facing prostate surgery usually had little choice as to the types of surgical procedures available. Typically, in conventional radical prostatectomy, a procedure in which the entire cancerous prostate gland is removed, surgery involves large open incisions in the lower abdomen, the risks of excessive blood loss during surgery, post-operative infections, long hospital stays, considerable pain, limited activity, and the dreaded loss of bladder control and sexual function due to severance of the delicate plexus of nerves around the walnut-sized prostate gland.

Now a new, minimally invasive surgical procedure uses finely controlled robotic instruments to perform the surgery more safely while enhancing patient recovery and outcome. While sitting at a computer console, the surgeon controls a robotic system that includes a high-resolution camera and micro-surgical instruments. The computer scales the surgeon's movements at the console to micro-movements, precisely guiding the robotic arms during the delicate surgery.

Unlike traditional laparoscopic micro-instruments, the robotic instruments can turn in all directions, allowing the surgeon to perform fine computer-controlled movements and to perform a more precise surgical procedure. This is particularly important when making every possible effort to spare the delicate nerves that control bladder and sexual function.

The high-resolution camera provides the surgeon with a highly magnified, three-dimensional view of the vital anatomical structures of the pelvis. Once the surgeon detaches the cancerous prostate with the robotic micro-instruments, the surgeon removes the tumerous gland through one of five small abdominal incisions. The surgeon then re-attaches the bladder to the urine channel over a catheter. The catheter is left in place for a short time to ensure proper healing. The surgery is completed with the removal of the instruments and the closure of the small incisions in the abdomen.

"This surgical system changes the experience of prostate surgery," said David B. Samadi, M.D., a urologic oncologist and laparoscopic surgeon. He performs conventional as well as laparoscopic radical prostatectomies at White Plains Hospital Center and New York United Medical Center in Port Chester and robotic prostatectomies at Columbia Presbyterian Medical Center in New York City. Dr. Samadi is one of only two surgeons in the New York City area and one of only five surgeons in the state qualified to perform the robotic prostatectomy. His background includes an oncology fellowship from a major New York City cancer institute and a laparoscopic fellowship in urology from his advanced training France.

"The robotic surgery is a much more precise procedure than conventional radical prostatectomy," Dr. Samadi explained. "The surgeon who performs this delicate procedure is not merely a technician. I draw upon my extensive experience and fellowship training in uro-oncology and laparoscopic surgery in order to perform the robotic surgery successfully."

"I think that this is the most exciting procedure in urology, and people are coming from all over the country to have this procedure done. Robotic prostatectomy offers patients shorter hospital stays, less pain, less risk of infection, less blood loss and transfusions, less scarring, a faster recovery, a quicker return to normal activities, greater cancer control, an early return of urine function, and enhanced preservation of sexual function," said Dr. Samadi.

For more information on robotic prostatectomy, contact Dr. Samadi at Columbia Presbyterian Medical Center at 2l2.305.9722 or visit his website at www.drdavidsainadi.com.

Reprinted with permission from The Rye Sound Shore Review.