NEW YORK, NY
While still considered an innovative and highly skilled technique, robotic prostate removal surgery seems to havecemented its place as a widespread prostate cancer treatment. In a retrospective review of close to 500,000 prostate removal surgeries from 2003 to 2010, instances of robotic-assisted radical prostatectomy (RARP) have increased dramatically. By 2010, researchers found that 42 percent of radical prostatectomy surgeons were performing the surgery robotically.
David B. Samadi, MD, Chairman of Urology and Chief of Robotic Surgery at Lenox Hill Hospital, was an early adopter of the procedure and now performs his own custom version, the Samadi Modified Advanced Robotic Technique (SMART) Surgery. To date he has performed more than 5,600 successful procedures.
“Robotic surgery has a lot to offer prostate cancer patients,” said Dr. Samadi. “In the hands of highly experienced surgeons, patients are seeing very positive results. The skill level of the surgeon is critical and patients must not confuse availability with expertise.”
Among the cases reviewed by researchers, the greatest increase in instances of robotic prostate surgery was seen among high-volume surgeons whose robotic procedures rose from 10 percent to 45 percent over the seven-year period. Additionally, high-volume surgical centers and teaching hospitals were more likely to adopt RARP.
While this particular study did not explore the reasons for the increased popularity of RARP, Dr. Samadi sees firsthand the benefits to both surgeons and patients.
“As a surgeon, my experience in the operating room and my ability to treat and counsel patients are significantly improved with the robot. I can see the surgical field more clearly, I can navigate delicate prostate tissue and nerves with ease, and ultimately, I can see the scope of the cancer directly.”
Dr. Samadi performs robotic prostate surgery using a remote robotic interface called the da Vinci Surgical System. During the RARP procedure he sits at a control panel near the operating table and guides the robotic arms through the procedure. A series of small incisions is made in the patient’s abdomen, resulting in significantly less blood loss than open surgery. The robot’s precision allows Dr. Samadi to remove the cancerous prostate as in open surgery, though with greater visibility and dexterity.
“Robotic surgery also gives patients a leg up for recovery,” said Dr. Samadi. “We can successfully see and remove the cancer, plus smaller incisions and less blood loss generally yield a faster recovery. The same is typically true of return to urinary continence and sexual potency. With the robot there’s simply less disruption to the body overall.”
Results of the RARP study were published in BJU International.