Until recently, men with prostate cancer had few prostate surgery choices. 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 risk of excessive blood loss, post-op infections, long hospital stays, and 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 severance of the delicate plexus of nerves around the prostate gland.
Prostate Cancer Treatment Through Prostatectomy
Over the last two decades there has been revolutionary improvement in medical surgical technology with 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.
A minimally invasive surgical procedure, called robotic prostatectomy, uses finely controlled robotic instruments to perform the prostatectomy safely, while enhancing patient recovery and outcome. Sitting at the da Vinci surgical console, Dr. Samadi performs robotic prostatectomy by controlling the device consisting of high-resolution cameras and micro-surgical instruments. Powered by state-of-the-art robotic technology, his hand movements are scaled, filtered, and seamlessly translated into precise movement of the EndoWrist Instruments.
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 Dr. Samadi 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.
DaVinci and SMART Robotic Prostate Surgery
Based on his clinical experiences, Dr. Samadi believes robotic prostatectomy overcomes the limitations of open and laparoscopic surgery.
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.
Precise Robotic Prostate Surgery
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 need 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.
Patient Side Cart
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.
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.
The majority of Dr. Samadi’s da Vinci robotic prostatectomy patients are discharged within 24 hours of their surgery. For most patients, Dr. Samadi’s use of the da Vinci Surgical System for robotic prostate surgery provides superior benefits over traditional open or laparoscopic prostatectomy, including*:
- Quicker return to normal activity
- Shorter hospitalization (most patients go home the next day)
- Reduced risk of complications such as incontinence and impotence
- Less blood loss and fewer transfusions
- Reduced pain
*As with any surgical procedure, the benefits of a da Vinci Surgical System cannot be guaranteed as surgery is both patient and procedure specific.