Robotic Prostate Cancer Surgery from Start to Finish

How does a doctor perform robotic prostate cancer surgery?

robotic prostate cancer surgeryPatients who are a candidate to undergo robotic prostate cancer surgery may want to know a little more about what the procedure entails. Dr. David Albala goes over the different steps of a typical robotic surgery procedure and sheds some light on the process in this short video.

After a patient is under anesthesia and the surgical space is prepared, a surgeon guides the robot from an adjacent control panel using hand and foot controls as well as a large video display. The surgery is considered completed when the surgeon has achieved their goal. The goals of robotic prostate cancer surgery include removing diseased tissues while maintaining negative margins. The procedure usually last between two and three hours.

For more information read “Dr. David Albala opens his operating room to showcase the da Vinci robot during prostate removal surgery.”

David Albala, MD: Typically, a patient is brought into the operating room and positioned, then you are put to sleep. Once you are asleep, essentially the surgeon and his assistant will make some small incisions on your abdomen and fill your belly up with carbon dioxide gas. What the carbon dioxide gas does, it creates a working space to allow the surgery to be done.

Once the working space has been created with the carbon dioxide gas, small little cylindrical tubes are placed into the abdomen that allow the placement of instruments into the abdominal cavity. Once those instruments have been placed in, a robot is then docked with these cylindrical tubes and one as a surgeon can go over to the console and maneuver these instruments using your hands and feet. Now what is interesting about the robot is the robot is a master slave type of arrangement, in other words the master sits at the control panel and he can move his hands in different directions which will control the movements of the instruments within the abdominal cavity.

The feet are actually used in robotic surgery for a number of things. If one wants to burn a particular blood vessel with an instrument, what you can do is step on a foot pedal that will activate the cautery or bipolar cautery. You can actually move the lens that is placed into the abdominal cavity with your feet. Your hands actually move it but when you step on a particular pedal, what that does is it can move the lens in and out and control the lens. So robotic surgeon now has to be facile with his hands but he uses his feet during the surgical procedure.

Now a robotic prostate cancer surgery can take, you know a variable amount of time depending on the experience of a surgeon. There are some surgeons in which typically takes two even three hours to do this surgery, some surgeons can do it in an hour. The surgical time, I don’t think, is a good indicator. I think what is important of a patient that is trying to choose a robotic surgeon is to look at the experience. Clearly, the literature suggests the more robotic cases a surgeon has done, probably the better outcomes he will have.

Dr. David Albala
Dr. David M. Albala is Chief of Urology at Crouse Hospital in Syracuse, New York and Medical Director for Associated Medical Professionals. He is considered a national and international authority in laparoscopic and robotic urological surgery and has been an active teacher in this area for over 20 years.

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