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

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da Vinci Prostatectomy

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

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da Vinci Prostatectomy is the #1 choice for treatment of localized prostate cancer in the United States, and is rapidly being chosen by more men, as well as their doctors, worldwide. da Vinci Prostatectomy is a minimally invasive, robotic-assisted surgical procedure that removes the cancerous prostate gland and related structures. Dr. Rosen and Dr. Arcangeli are recognized by the medical community to be outstanding prostate cancer surgeons, and have years of experience with da Vinci robotic prostate cancer surgery.

The da Vinci Surgical System from Intuitive Surgical, Inc. enhances surgical capabilities, providing superior visualization, enhanced dexterity, greater precision and ergonomic comfort. 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

A number of recent studies suggest that da Vinci prostatectomy offers several benefits compared to other prostate cancer treatments. Potential benefits of the da Vinci Prostatectomy include:

Effective Cancer Control: Studies have shown that experienced surgeons have achieved excellent results in removing prostate cancer without leaving cancer cells behind.

Improved and Early Return of Sexual Function: Studies have shown that most patients have a rapid return of sexual function.

Improved and Early Return of Continence: Studies have shown that most patients have a rapid return of urinary continence.

Improved Results Over Traditional Treatments: Patients may benefit from surgical treatment of localized prostate cancer, the established gold standard, as compared to radiation. Surgery has a higher and longer survival rate than radiation or other treatments. Surgery also has a lower risk of long-term complications than radiation treatments.

Minimally Invasive Surgery: The da Vinci System enables surgeons to perform even the most complex and delicate procedures through very small incisions with unmatched precision.

The da 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?

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 1-2 days. During da Vinci prostatectomy we are able to make a very precise surgical connection between the bladder and the urethra, so most patients have a catheter for only 5-7 days compared to 2-3 weeks following open surgery. Men are able to return to most normal activities within 2 weeks of surgery. da Vinci prostatectomy allows more gentle handling of the prostate, urethra, and nerves so that patients recover urinary control and sexual function quicker than after open surgery so patients have return of normal urinary control and sexual function faster than after open prostate surgery. Men considering da Vinci prostatectomy should discuss the recovery process with their urologic surgeon so that they know exactly what to expect after 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. Men must be able to tolerate general anesthesia for 3-4 hours, so men with serious breathing problems are not good candidates. Men who have had multiple abdominal surgeries or who have very large prostates may be better suited to open surgery.

“Patient’s Guide to da Vinci Prostatectomy”

Click here to learn more about the hospital stay and recovery for da Vinci prostatectomy, including instructions for preoperative bowel preparation and ways to improve the recovery of sexual function after surgery,