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Prostate Cancer Surgery

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Posted 11/21/2013

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Dr. Chad LaGrange explains the benefits of minimally invasive robotic surgery to treat prostate cancer. To learn more, call 1-800-922-0000 or visit http://www.nebraskamed.com.

Read a transcript of this video

Prostatectomy remains the most common form of therapy for prostate cancer. The advantage of robotic is more of an improvement in getting better and quicker. In general, doing a prostatectomy, a minimally invasive approach offers the benefit of less blood loss, which is big, and a quicker patient recovery are two of the major things that are really a benefit.

A patient it usually in the hospital after a minimally invasive prostatectomy for one or two, maybe three, nights depending on their clinical course, as opposed to doing it through a bigger incisions where it could easily be four or five nights.

They can do more strenuous activity quicker; there’s less chance of hernias and wound problems and things like that. And so overall there’s just a quicker recovery over the standard incision approach. Where an incision is made from about the umbilicus until the pubic bone and the then incision is the muscle is spread and the prostate and bladder exposed. And so you end up with an incision about the length of your hand. Whereas with minimally invasive prostatectomy, depending on how it’s done, laparoscopically or robotically, you end up with four or five pen hole or keyhole incisions. And then one small incision to extract the prostate and that’s usually at the umbilicus; overall, the incision is much much less.

So the advantage of doing it robotic is it’s much more comfortable and natural for the surgeon and the reason why is because the surgeon is able to manipulate the robotic arms inside the human body in much the same way that he would move his own hands, in fact, it’s exactly the way you would move your own hands. And so it’s a very intuitive procedure in terms of the motion of your hands and the motion of the instruments; it allows you to accomplish a lot more with a lot less strain. So that’s the real advantage to the surgeon of robotic surgery; it allows us to do more precise and complicated movements much easier. The robot only does exactly what we do with our own hands; it mimics every movement up to the smallest detail. So we set at a console just a few feet away from the surgical bed and our head is in a view box and we see in 3D in the view box, and that’s an advantage of doing it robotically; you have excellent vision even compared to laparoscopic, which has good vision with magnification. With the robot you have magnification and 3D. So you have depth perception.

So anytime you remove the prostate gland or whatever approach it may be, there are several side effects or risks that can happen. The very well known one is erectile dysfunction. The other one is incontinence. And then there can also be just general complications such as bleeding or infection. What we found with the robotic approach or laparoscopic approach is that the risk of bleeding obviously is much much less. But overall, the other complications such as erectile dysfunction and incontinence are essentially the same, if not a little bit better than by doing it via open approach. And so that is one thing we are always focus on and just to make sure that what we’re doing is at least equal and hopefully better and in most cases it is better than the open approach. And in terms of cancer cure rates, the use of the robot of laparoscopic surgery has been shown to at least be equal once again in terms of cure rates and in most situations, better in many studies better than the open approach in terms of cure of cancer.

It’s already a very common approach for good reason and I think in the future it will just continue to be refined. We’re also starting to move toward doing these really minimally invasive prostatectomy’s where you may not even hardly be able to see a scar at all after we’re done. And we would just go through one small incision at the umbilicus and so that’s something that we’re working on and I think in the future will also be a possibility.