While many hospitals offer “robotic surgery,” it is important for patients to understand that the robot is simply a tool. The clinical outcome—the “Trifecta” of cancer cure, continence, and potency—is determined by the surgeon’s specific technique and experience level. While both procedures utilize the da Vinci Robotic System, Dr. David Samadi’s proprietary SMART Surgery differs fundamentally from traditional robotic methods.
Having performed over 10,000 successful procedures, Dr. Samadi refined the SMART (Samadi Modified Advanced Robotic Technique) approach to overcome the functional limitations of standard robotic prostatectomies.
The “Inside-Out” Surgical Philosophy
The most significant difference lies in the surgical path. Traditional robotic surgery typically approaches the prostate from the outside in. This often requires the surgeon to cut through or manipulate the surrounding protective tissues to reach the gland.
Dr. Samadi’s SMART technique utilizes an “Inside-Out” approach. By navigating from the interior of the pelvic floor outward, he can remove the prostate with minimal disruption to the critical functional zones on the exterior. This precision is what allows for the preservation of the delicate nerves and muscles that control erections and urinary flow.
Preservation of Support Structures
In a traditional robotic prostatectomy, surgeons often cut the Endopelvic Fascia and suture the Dorsal Vein Complex to manage bleeding and gain access. However, these structures provide the anatomical support for the urinary sphincter.
In the SMART procedure, Dr. Samadi leaves the Endopelvic Fascia completely intact and does not suture the dorsal vein. By avoiding these maneuvers, he maintains the natural structural integrity of the pelvic floor, which is why SMART surgery patients often experience a near-immediate return of urinary control.
Athermal (Heat-Free) Nerve Sparing
Traditional robotic surgery frequently relies on cautery (electric heat) to seal blood vessels. Because heat can travel through tissue, it poses a significant risk to the microscopic neurovascular bundles responsible for sexual function.
Dr. Samadi utilizes a strictly athermal technique near the nerves. By using “cold” surgical clips and scissors instead of electricity, he ensures that the biological circuitry for potency remains live and undamaged by thermal spread.
Efficiency and Recovery
Experience leads to efficiency. A traditional robotic prostatectomy in less experienced hands can take several hours. Dr. Samadi typically completes the SMART procedure in under 90 minutes.
Reducing the time a patient spends under anesthesia results in:
- Less blood loss and lower risk of infection.
- Reduced inflammation in the surgical site.
- Faster overall recovery, allowing patients to return to their daily lives much sooner than traditional benchmarks.
Frequently Asked Questions
If both use the da Vinci robot, why are the results different?
The robot does not perform the surgery; the surgeon does. Dr. Samadi’s modifications—specifically the inside-out approach and the avoidance of heat—are unique to his SMART protocol and are not part of “standard” robotic training.
Is SMART surgery safer for cancer control?
Oncological safety is the primary goal. Dr. Samadi’s high-volume experience allows him to identify the exact margins of the cancer with 10x 3D magnification, ensuring a cancer-free result while sparing the surrounding healthy tissue.
How long is the hospital stay?
Due to the efficiency and minimally invasive nature of the SMART technique, most patients are able to return home within 24 hours of their procedure.
Choose Innovation Over Tradition
When facing prostate cancer, the technique your surgeon uses will define your quality of life for years to come. Dr. David Samadi offers a proven, proprietary path to a full recovery.
Contact the Samadi Robotics Center:
- Surgeon: Dr. David Samadi
- Website: roboticoncology.com
- Phone: 212-365-5000
- Manhattan Address: 485 Madison Avenue, 21st Floor, New York, NY 10022
- Long Island Address: 2200 Northern Blvd, Suite 120, East Hills, NY 11548
212-365-5000