Advanced Surgical
Treatment for Prostatectomy
January / February 2006
Robotic
laparoscopic
prostatectomy
offers
advantages
to patients.
As an alternative surgical treatment
for radical prostatectomy, robotic
laparoscopic prostatectomy offers less blood loss and
shorter recovery time than open prostatectomy.
The treatment is one of several surgical
options for prostate cancer available at Penn
Presbyterian Medical Center.
The minimally invasive, high-tech
procedure involves the total surgical removal
of the prostate through small incisions using
various robotic surgical instruments. The
effectiveness of the robot results from the
intricacy of the machine. It consists of a tower
that manipulates instruments, which are
controlled by a console. At the console,
surgeons operate four robotic arms using hand
and foot controls. One of the robotic arms
holds a tiny video camera, one works as a
retractor and the other two replicate the
surgeon's exact hand movements.
There are several advantages
to robotic laparoscopy over standard laparoscopic
prostatectomy. The robot's camera consists of
two separate lenses, which offer surgeons a
3D view inside the patient. This stereoscopic
image of the interior of the patient offers
depth perception, further improving the
surgical field of vision.
Robotic Precision
“I can scale the motions to complete very
precise work,” says David
Lee, MD, Chief of
the Division of Urology at Penn Presbyterian
Medical Center and assistant professor of
surgery, Division of Urology, University of
Pennsylvania School of Medicine. Dr. Lee
helped perform the first 57 laparoscopic
prostatectomies in Southern California. Until
recently, he was the director of Laparoscopic
and Robotic Surgery at Urology Associates of
North Texas, the largest urology private
practice group in the country.
During a radical prostatectomy,
surgeons work in a very tight, narrow field. After the
prostate is removed, the bladder must be sewn
back to the urethra deep within the pelvis. “The robot
is ideal for this kind of
reconstruction surgery,” says Dr. Lee. “It allows
you to do very fine suturing, which is
difficult to perform in open and standard
laparoscopic surgeries.”
Patient Benefits
According to Dr. Lee, more than 95 percent
of patients go home the day after surgery and the
urinary catheter can usually be removed in one
week. “Early results demonstrate that robotic
prostatectomy may offer better continence and
potency after surgery,” says Dr. Lee. “I've
also
found that blood loss is decreased with this
technique. Typically, blood loss can be about
100 cc. With open surgery, it's much more likely
to have significant blood loss.”
Prostate cancer is
the second leading cause of cancer death in American men,
exceeded only by lung cancer. About one in six will be
diagnosed with prostate cancer and on average,
one in 34 will die of the disease, according to
the American Cancer Society.
All prostate cancer patients are
potential
candidates for robotic laparoscopic
prostatectomy. “At this juncture, the difficulties
with large or small prostates or large patients
have been minimized,” says Dr. Lee. “Our
surgeons work closely with referring physicians
and are available for consult if a physician has
any questions about treatment or the procedure.”
For more information, visit the robotic
prostatectomy web site.
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Referring Physicians: To speak with a Penn physician
or refer a patient, contact PennHealth through the secure online
referral form or by calling
1-800-789-PENN
(7366). |
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