Da Vinci prostatectomy is considered to be the most advanced prostate cancer treatment option. Robotic prostate surgery is recommended especially for patients with localized prostate cancer. Da Vinci prostatectomy is the result of modern technology and medical research.
Until recently, men with prostate cancer had few prostate surgery choices. Due to the recent technological breakthroughs, prostate surgery with the da Vinci robot is now considered one of the best treatment options for prostate cancer.
But what triggered the appearance of robotic prostate surgery on the medical landscape and why might it be an option for you?
Do you know the risks of open prostate surgery?
Historically, the only prostate surgery option was open prostatectomy, involving large incisions and post-operative side effects. Using this procedure, the entire cancerous prostate was removed with the risk of:
- excessive blood loss
- post-op infections
- long hospital stays
- considerable pain.
Following open prostatectomy, patient activity was limited and often resulted in a loss of bladder control and sexual function after prostate surgery due to the severance of the delicate plexus of nerves around the prostate gland.
The da Vinci prostatectomy for prostate cancer – Why so popular?
Over the last three decades, there has been a revolutionary improvement in medical-surgical technology with a great impact on prostate cancer treatment and prostatectomy.
The most famous robotic prostatectomy available today involves the da Vinci Surgical System, manufactured by Intuitive Surgical.
Robotic prostatectomy is gaining popularity as a less traumatic and minimally invasive prostate cancer treatment.
The da Vinci robotic prostatectomy enables surgeons to overcome many of the shortcomings of both open prostatectomy and laparoscopic prostatectomy.
This minimally invasive surgical procedure, called da Vinci robotic prostatectomy, uses finely controlled robotic instruments to perform the prostatectomy safely while enhancing patient recovery and outcome.
Important facts about the da Vinci Prostatectomy
Although it has fastly evolved in the last few years, the da Vinci Surgical System is not a new procedure. It was introduced in 1999 by Intuitive Surgical.
- The first da Vinci prostatectomy in the world was performed in 2000, in Frankfurt, Germany.
- Nowadays, there are more than 1,700 da Vinci robots available in hospitals worldwide.
- There are more than 775,000 patients worldwide who have had a da Vinci procedure
- 3 out of 4 prostate cancer surgeries in the US are performed by means of the da Vinci robot
- Robotic prostatectomy performed with the help of the da Vinci machine has the lowest death rates, compared to radiation
- All top-ranked hospitals in the US have at least one da Vinci robot
There is no doubt we live in the era of robotic surgeries. It should not surprise us, considering all the great benefits of robotic prostate surgeries.
Back in 2002, Dr. David Samadi accomplished a robotic radical prostatectomy fellowship at Henri Mondor Hospital Creteil in Paris, France. Since then, Dr. Samadi has performed over 7,000 successful prostate surgeries using the da Vinci robot. What is more, Dr. Samadi has succeeded in modifying the procedure, creating a revolutionary approach, known as SMART Surgery.
The benefits of da Vinci Robotic Prostatectomy
The majority of patients who have undergone the da Vinci robotic prostatectomy are discharged within 24 hours of their surgery.
The main benefits of the da Vinci robotic prostatectomy are:
- Quicker return to normal activity
- Shorter hospitalization (most patients go home the next day)
- Less blood loss and fewer transfusions
- Reduced pain
Also, robotic prostatectomy is the only procedure that can ensure the trifecta of prostate cancer survivorship:
- Preservation of sexual function after prostate surgery
- Regain continence after surgery
- Be cancer-free and have zero PSA after prostatectomy
All these benefits make the da Vinci robotic prostatectomy the first-line treatment recommended for prostate cancer.
How is the da Vinci surgery for prostate cancer performed?
Sitting at the robot’s surgical console, the surgeon performs robotic prostatectomy by controlling the device consisting of:
- high-resolution cameras
- micro-surgical instruments.
Powered by state-of-the-art robotic technology, his hand movements are scaled, filtered, and seamlessly translated into the precise movement of the EndoWrist Instruments.
DaVinci Prostatectomy – Video explanation
The main components of the da Vinci Robotic System for prostate removal
1. Computer 3-D Visualization
Robotic prostate surgery gives surgeons the feeling that their hands are immersed in the patient’s body, even though they are performing the surgery remotely. All movements of the surgeon’s hands are micro-scaled by the da Vinci robot. As a result, the surgeon feels completely connected to surgery.
Robotic prostatectomy provides a much brighter and sharper image than the human eye or any other 3-D laparoscopic prostatectomy endoscope. The robotic prostate surgery system incorporates a proprietary camera that allows the surgeon to easily zoom, rotate, or change the image visualization.
The resulting 3-D image is bright and clear, with no flicker as with other laparoscopic systems. Robotic hand simulation and 3-D visualization make the da Vinci robotic prostatectomy more advanced than other minimally invasive surgical procedures currently available.
2. The da Vinci robot has a motion scaling feature
Using the da Vinci System for robotic prostatectomy, the surgeon can use “motion scaling,” a feature that translates small hand movements outside the patient’s body into precise movements inside the body.
The surgeon controls the robotic prostate surgery robotic arms from the da Vinci console using natural hand and wrist movements. Motion scaling during robotic prostatectomy is designed to allow greater precision than is normally achievable in open and laparoscopic prostatectomy surgery. Indeed, conventional laparoscopic instruments provide surgeons less flexibility, dexterity, and range of motion.
Proprietary instruments called EndoWrist and enhanced range-of-motion of robotic arms enable surgeons to reach difficult places and to operate safely in the confined space of the closed chest, abdomen, or pelvis.
Laparoscopic instruments in use today do not replicate hand movements and cannot perform precise movement and manipulations needed for robotic prostate surgery, such as reaching behind tissues, suturing, and dissection. The system also filters out unpredictable movements and tremors inherent in human hands.
3. The Patient-Side Cart of the da Vinci surgical system
During a robotic prostatectomy, the patient-side cart is positioned next to the operating table with the da Vinci robotic arms arranged to provide entry points into the human body and prostate. EndoWrist instruments, and the da Vinci Insite Vision System, are mounted onto the robot’s electromechanical arms representing the surgeon’s left and right hands.
They provide the functionality to perform complex tissue manipulation through the entry points, or ports. EndoWrist instruments include forceps, scissors, electrocautery, scalpels, and other surgical tools. If the surgeon needs to change an Endowrist instrument, common during robotic prostatectomy, the instrument is withdrawn from the surgical system using controls at the console. Typically, an operating room nurse standing near the patient physically removes the EndoWrist instruments and replaces them with new instruments.
4. The Surgeon Console
The surgeon performs the robotic prostatectomy while sitting at the console, manipulating the hand controls, and viewing the operation live through the da Vinci Insite Vision System. This is more comfortable for the surgeon and reduces operating fatigue, a known hindrance in open surgery.
The robotic prostatectomy is completed with the removal of the da Vinci instruments and closure of the small incisions in the abdomen with sutures.
Dr. Samadi’s patient testimonials and media coverage attest to his robotic prostate surgery and prostate cancer treatment expertise. He has performed over 7,000+ robotic prostate procedures.
Robotic prostatectomy cost
There are more than 1,700 da Vinci robots in the world and their cost is not neglectable.
The system is used in a variety of medical procedures, but especially in urological ones.
A study published in the Jama Network states that even if the robotic-assisted radical prostatectomy is firstly associated with a higher cost (2367$), the spendings are fully attenuated after a year. This is because there will be fewer doctor appointments, complications, or functional side effects.
Why do surgeons prefer using robots in urological surgeries?
- improved visualization
- movement flexibility
- short-time procedure (2-4 hours)
The robot has proven its cost-effectiveness by the fact that patients experience less blood loss, faster recovery, and less pain. Also, the recovery of continence and sexual function is earlier. All these are good reasons to prove the efficiency of robotic prostatectomy.
Da Vinci prostatectomy compared with laparoscopic prostatectomy
Unlike laparoscopic surgery, da Vinci Surgical System instruments used in robotic prostatectomy can turn in all directions with 90 degrees of articulation and 7 degrees of freedom.
During robotic prostate surgery, the da Vinci robot provides the surgeon with improved visualization, dexterity, and precision compared with open or laparoscopic surgery, while enabling operation through 1-2 cm incisions. This allows the surgeon to perform fine computer-controlled movements and a more precise and minimally invasive robotic prostatectomy.
During this prostate cancer treatment, his patients’ delicate prostate nerves that control bladder and sexual function are spared. Robotic prostatectomy achieves the same or better prostate cancer treatment results than a surgeon’s own hands in open or laparoscopic surgery.
Why is Dr. David Samadi considered one of the best prostate cancer robotic surgeons in NYC?
Dr. David Samadi has made the goal of helping people his life mission. He has dedicated his entire life to the treatment of prostate cancer, the second leading cause of death in America. Men need better care, and this is what Dr. Samadi is striving to accomplish with every patient passing his office door, in New York City.
With over 2 decades of experience in the urology field, Dr. Samadi has gained the appreciation of both medical communities around the world and the thousands of patients who became cancer-free.
Also, being a pioneer in the field of robotic prostatectomy, Dr. Samadi has trained doctors all around the world in this new da Vinci technique. For example, hospitals in Israel and the Dominican Republic have highly benefited from his extensive medical knowledge.
If you would like to receive personalized advice to know whether or not you are eligible for radical prostatectomy, do not hesitate to contact Dr. David Samadi.