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| DAVID B. SAMADI, M.D. |
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Chief, Division of Robotics and
Minimal Invasive Surgery
Mount Sinai School of Medicine |
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| PROSTATE CANCER TREATMENT - DA VINCI ROBOTIC SURGERY |
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Until recently, men facing prostate cancer surgery usually had little choice as to the types of surgical procedures available. Surgery has been traditionally performed in an open manner, called open prostatectomy, which involves large incisions and post operative side effects for patients. Using this procedure, the entire cancerous prostate glad is removed and there are risks of excessive blood loss during surgery, post-operative infections, long hospital stays, and considerable pain. Following open prostatectomy surgery, patients have limited activity, and may lose bladder control and sexual function due to severance of the delicate plexus of nerves around the walnut-sized prostate gland.
The last decades have experienced a revolutionary improvement in medical surgical technology. Da Vinci Robotic Prostatectomy surgery is gaining popularity as a less traumatic and minimally invasive alternative for treating and removing prostate cancer. The most famous robotic prostatectomy system available today is the da Vinci Robot manufactured by Intuitive Surgical. The da Vinci robotic system enables surgeons to overcome many of the shortcomings of both open prostatectomy and laparoscopic radical prostatectomy.
Complication Rates
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Click here to download PDF |
Dr. Samadi’s minimally invasive surgical procedure called a robotic prostatectomy, uses finely controlled robotic instruments to perform the surgery more safely while enhancing patient recovery and outcome. While sitting at a da Vinci Robotic console, Dr. Samadi controls the device consisting of high-resolution cameras and micro-surgical instruments. The da Vinci Prostatectomy computer scales his movements to micro-movements, precisely guiding the robotic arms during the prostate cancer surgery.
Unlike laparoscopic surgery, da Vinci Robotic Prostatectomy instruments can turn in all directions with 90 degrees of articulation and 7 degrees of freedom. The da Vinci system 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 Dr. Samadi to perform fine computer-controlled movements and to perform a more precise and minimally invasive prostate surgery procedure, which protect his patient’s delicate prostate nerves controlling bladder and sexual function. The da Vinci Robot achieves the same or better results of a surgeon’s hands in open or laparoscopic surgery.
Based on his clinical experiences, Dr. Samadi concludes that the da Vinci Robotic Prostatectomy overcomes the limitations of open and laparoscopic surgery: |
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| Da Vinci Robotic Prostatectomy - How It Works |
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Robotic Prostatectomy:
ergonomically designed surgeon’s console IntuitiveSurgical | Robotic Prostatectomy:
patient-side cart with four interactive robotic arms
IntuitiveSurgical | Robotic Prostatectomy:
proprietary EndoWrist® Instruments
IntuitiveSurgical | Robotic Prostatectomy:
high-performance InSite® Vision System
IntuitiveSurgical |
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Powered by state-of-the-art robotic technology, the surgeon’s hand movements are scaled, filtered and seamlessly translated into precise movement of the EndoWrist Instruments.
Computer 3-D Visualization - The robotic prostatectomy system 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. The da Vinci robotic system provides a much brighter and sharper image than the human eye, or any other 3-D laparoscopic prostatectomy endoscope. The 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 system more advanced than other minimally invasive surgical procedures available currently.
Precise Robotic Assisted Prostate Surgery - Using the da Vinci System, 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 da Vinci Robotic Prostatectomy robot from the console using natural hand and wrist movements. Proprietary instruments called EndoWrist instruments enable surgeons to reach difficult places in the prostate and suture with precision. Motion scaling 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. Laparoscopic instruments in use today do not replicate hand movements and cannot perform precise movement and manipulations, such as reaching behind tissues, suturing, and dissection. Added instrument range-of-motion enhances access and safety while operating in the confined space of the closed chest, abdomen or pelvis. The system filters out unpredictable movements and tremors inherent in human hands.
Robotic Assisted Prostate Surgery using the da Vinci Surgical System – During a procedure, the 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 Insight Vision System, are mounted onto the robot’s electromechanical arms representing the surgeon’s left and right hands and provide functionality to perform complex tissue manipulation through the entry points, or ports. Endowrist instruments include forceps, scissors, electrocautery, scalpels and other surgical tools. Endowrist instruments are selected and changed during the robotic prostatectomy. If the surgeon needs to change an Endowrist, as is common during a robotic prostatectomy procedure, 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.
The surgeon performs the robotic prostatectomy while sitting comfortably at the console, manipulating the hand controls and viewing the operation live through the da Vinci Robot’s InSight vision system. This is more comfortable for the surgeon and reduces operating fatigue, a known hindrance in open surgery. The robotic assisted prostate surgery is completed with the removal of the da Vinci prostatectomy instruments and closure of the small incisions in the abdomen with sutures.
Dr. Samadi’s patient testimonials and media coverage attest to his robotic prostatectomy expertise. Dr. Samadi has performed over 3,000 robotic prostatectomy procedures. The majority of Dr. Samadi’s da Vinci Robotic Prostatectomy patients are discharged within 24- hours of their surgery. Many patients leave the same day, and often walk out of the hospital within hours of their robotic prostatectomy surgery. For most patients, Dr. Samadi’s use of the da Vinci Prostatectomy provides superior benefits over traditional open or laparoscopic prostatectomy, including*: |
Summary of Da Vinci Robotic Prostatectomy Benefits:
Time in OR
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As with any surgical procedure, the benefits of a da Vinci Prostatectomy cannot be guaranteed as surgery is both patient and procedure specific.
Additional Information about da Vinci Robotic Prostatectomy System.
The da Vinci Robotic Prostatectomy System (Intuitive Surgical), is the first totally "intuitive" laparoscopic surgical robot in existence. As of today, the FDA has cleared the da Vinci Robotic System for use in performing many surgical procedures including general laparoscopic surgery, thoracoscopic (chest) surgery, laparoscopic radical prostatectomies and thoracoscopically assisted cardiotomy procedures. Additionally, the da Vinci Prostatectomy System is also presently involved in a cardiac clinical trial in the United States for totally endoscopic coronary artery bypass graft surgery.
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I was discharged from the hospital the day after surgery and my catheter was removed in four days. A month and a half after the surgery, I took a two week car trip to Canada by myself. Two years after the surgery I married a wonderful woman and we are living a happy life together... 
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