Urologic Oncology Expert and Robotic Surgeon
Surgeons who manage patients with prostate cancer must understand the advantages and disadvantages of each available prostate cancer treatment and prostate surgery in order to optimize outcomes. Traditional, open prostate surgery effectively removes cancer, but has been associated with longer and more painful hospitalizations, significant blood loss, incontinence, and sexual dysfunction. The more recently developed laparoscopic prostate surgery represents a major advancement for patients with prostate cancer because it involves no incision, minimized blood loss and postoperative complications, andenables patients to recover more quickly with less pain. However, there is a steep learning curve associated with the laparoscopic approach; about 100 procedures before the technique is mastered.
A recent addition to prostate cancer treatment is robotic prostate surgery. The procedure has the same advantages associated with laparoscopic prostate surgery—no incision, minimum blood loss, fast recovery, and minimal catheter use—but the new technology uses robotic instrumentation and two cameras for better visualization. Using two cameras enables us to ascertain a three-dimensional view of the anatomy with greater magnification. And unlike laparoscopic prostate surgery, the robotic instrumentation provides surgeons with a full range of motion, and is associated with significantly less blood loss during prostate cancer treatment. For this reason, robotic assisted prostate surgery is sometimes called bloodless prostate cancer treatment. In addition, sexual dysfunction and incontinence risks are reduced with this prostate surgery because the surgeon has a clear view of the anatomy and can more accurately navigate around the nerves and structures responsible for these problems.
Few surgeons in the United States are trained in all three methods of prostate cancer surgery, but it can greatly benefit patient outcomes if expertise is achieved in each approach, as is the case with David B. Samadi, MD. Surgeons must be skilled at laparoscopy in order to be an excellent robotic surgeon, but they must also be adept at performing the open procedure in order to obtain experience with laparoscopy. Robotic prostate surgery combines the best of open prostate surgery and laparoscopy skills. There are very few cases in which a robotic or laparoscopic procedure must be converted to an open surgery, but choosing a prostate cancer surgeon who can handle any situation that arises is a must.