Cutting Edge

12/04/2005

Medical progress is measured in many ways. As robotic surgery comes of age, Katrina's victims struggle to find the most basic care. A look ahead.



Photo illustration by Newsweek; photograph by Adam Friedberg for Newsweek

By Jennifer Barrett
Newsweek
Updated: 2:57 p.m. ET Dec. 4, 2005


Dec. 12, 2005 issue - Stuart Forbes celebrated his 60th birthday on April 11. A week later, he was diagnosed with prostate cancer. "It was quite a month," says Forbes, a blunt Vietnam veteran who runs a consulting firm outside Boston. When biopsies confirmed he had an aggressive form of the disease, Forbes started looking for a surgeon. The first recommended a traditional radical prostatectomy, which would require an eight- to 10-inch incision and at least two days in the hospital. Forbes was also warned that he would likely lose almost all the nerves on the left side of the prostate, which could permanently affect his sexual function. "I thought, 'I need to really look at all my options'," says Forbes. He considered high-intensity focused ultrasound ablation, a relatively new technology that's been used in Europe. But it's expensive and would require transatlantic trips. He looked into various forms of radiation, as well as proton-beam therapy. Then, in June, his girlfriend took him to a symposium on robotic surgery. "I saw the machine and how it worked," remembers Forbes. "It was just incredible. I said, 'That's it'."

Five years ago, says Dr. David B. Samadi, director of robotic laparoscopic urology surgery at NewYork-Presbyterian Hospital/ Columbia Medical Center, 80 to 90 percent of the prostatectomies he did were open, with less than 10 percent done robotically. Now the figures have reversed. "There is much less blood loss and an extremely low rate of complications," he says.

The next frontier for robotic surgery may be gynecological laparoscopic procedures, for which the system was just approved this spring. There are about five times as many hysterectomies as prostatectomies performed each year, and surgeons say the complex procedure could benefit from the robotic system's precision. Cardiac surgeons have also begun using the da Vinci for a range of procedures, from mitral-valve repair to coronary-bypass surgery.



Photo illustration by Newsweek; photograph by Adam Friedberg for Newsweek (stereo viewer); courtesy of Intuitive Surgical Inc. (3-D image)

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