For those men diagnosed with “aggressive”, organ-confined carcinoma of the prostate, and who are candidates for surgery, the robotic-assisted laparoscopic prostatectomy is now the Gold Standard.
The use of this technique has increased dramatically, from approximately 9,000 such procedures done in 2004 to more than 66,000 in 2009, according to data presented at this year’s meeting of the American Urologic Association. The projected use of this technique is accelerating rapidly.
Both patients and surgeons are gravitating to this technique because there is no significant incision. Therefore, there is less pain, little, if any, blood loss, and a more rapid return to full and normal daily activities.
Utilizing the daVinci robotic system at Cedars-Sinai Medical Center in Los Angeles, our team at Tower Urology has refined our nerve-sparing, continence-preserving technique to allow patients to be discharged from the hospital generally within 24 hours of their surgery with minimal post-operative pain.
What is unique about the daVinci robotic system is the enhanced manual dexterity the surgeon can employ, rotating the robotic arm 360 degrees (compared to a maximum of 180 degrees without use of the robotic arm), and angulating the instrument to permit minute dissection in areas not accessible with standard laparoscopic or open surgical techniques. This makes possible a more precise attachment of the bladder neck to the urethra after the prostate is surgically removed, and better preserves the mechanisms of continence and potency, when compared to open or non-robotic assisted laparoscopic techniques.
The improvement in outcome has been dramatic! The key to success is finding the experienced surgical team operating at a world-class, state-of-the-art facility.
Dudley S. Danoff, MD, FACS is the attending urologic surgeon and founder/president of the Cedars-Sinai Medical Center Tower Urology Group in Los Angeles, California. He is the author of Penis Power: The Ultimate Guide To Male Sexual Health (Del Monaco Press, 2011) and Superpotency (Warner Books).
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