Carlos G. Arcangeli, MD & Mark A. Rosen, MD

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da Vinci Prostatectomy: Prostate Cancer Surgery Using the da Vinci® Surgical System

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Click here to view a short video about the revolutionary da Vinci® Surgical System.

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What is the da Vinci® Surgical System?

The da Vinci Surgical System from Intuitive Surgical, Inc. enhances surgical capabilities, providing superior visualization, enhanced dexterity, greater precision and ergonomic comfort. As a result of these capabilities, surgeons can now perform even complex surgery using 1-2 cm incisions. This enables our urolgists to offer minimally-invasive prostate cancer surgery to the broadest possible range of patients. Advantages to the patient include:

• Reduced trauma to the body
• Reduced blood loss and need for transfusions
• Less post-operative pain and discomfort
• Less risk of infection
• Shorter hospital stay
• Faster recovery and return to normal daily activities
• Less scarring and improved cosmesis

Moreover, recent studies suggest that da Vinci prostatectomy may offer improved cancer control and a lower incidence of impotence and urinary incontinence. The Vinci® Surgical System is used in over 400 hospitals around the world for prostate cancer and kidney surgery, obesity and stomach surgery, cardiac bypass, hysterectomy and other operations. The da Vinci Surgical System has been successfully used in tens of thousands of minimally invasive procedures worldwide.

How does the da Vinci® Surgical System work?

The da Vinci Surgical System consists of an ergonomically designed surgeon’s console, a patient-side cart with four interactive robotic arms, a high-performance vision system and proprietary EndoWrist® Instruments. Powered by state-of-the-art robotic technology, the surgeon’s hand movements are scaled, filtered and seamlessly translated into precise movements of the EndoWrist Instruments.

The System cannot be programmed, nor can it make decisions on its own. The da Vinci System requires that every surgical maneuver be performed with direct input from your surgeon.

Your surgeon will be in the operating room with you and help prepare you for surgery. After the patient is asleep and the small incisions are made for the instruments, the surgeon sits at the operating console. The surgeon views an actual image of the surgical field and operates in real-time, using instruments which are moved by the surgical robot. The robotic arms move precisely according to the movement of the surgeon’s hands, allowing the surgeon to perform the surgery faster, with more precision and less trauma to the patient.

Several features of the da Vinci® Surgical System contribute to the superior surgical outcomes. The surgeon looks through binocular eye pieces which show the view from the surgical field in 3-dimensional vision, and also magnify the image up to 10 times. The superior magnification and depth of field provided by the da Vinci® Surgical System greatly enhances the ability to perform delicate nerve-sparing surgery. The surgeons hands fit into “pincher-grip” hand controls in the console which move the robotic instruments inside the patient. The da Vinci® Surgical System utilizes motion scaling, so that larger movements of the surgeons’s hands are turned into smaller movements of the surgical instruments, which allows much more precise surgical disssection and suturing. In addition, the instruments of the da Vinci® Surgical System have “wrist-like” movement, which allows them to move in the same way as the human hand can move. This allows the surgeon to make precise, complex movements that cannot be performed easily with standard laparoscopy or open surgery.

What are the advantages of da Vinci Prostatectomy?

There is considerable evidence that da Vinci prostatectomy offers the same cancer cure rate as traditional open cancer surgery, with improved patient outcomes. The risk of blood transfusion during surgery (1%) is much lower than open surgery, and the average hospital stay after surgery is less than 24 hours. Most patients have a catheter for only 5-7 days, and are able to return to most normal activities within 2 weeks of surgery. Our experience with minimally-invasive prostate surgery is that patients have return of normal urinary control and sexual function faster than after open prostate surgery.

Who is a candidate for da Vinci Prostatectomy?

There are a number of excellent treatment options for localized prostate cancer. Most men who wish to have surgery are good candidates for da Vinci Prostatectomy. Rare patients who have had multiple abdominal or pelvic surgeries may not be able to have minimally-invasive surgery, and most of these men are better suited by other types of treatments. Our urologists are prostate treatment experts who can help men decide which treatment is best for them.