Three weeks after his prostatectomy, the 71-year-old patient was back doing what he enjoys: his yardwork, walking his dog and riding his bike. He's come a long way from the gut-wrenching anxiety he felt after being diagnosed with prostate cancer this summer. "I'm doing very well," says the man who had his surgery on a Tuesday and was discharged by Thursday. "I was on pain pills for only three days. Everything went very well."
Until recently, he would have undergone a traditional prostatectomy, which involves an incision about 15 to 23 centimeters long from the belly button to the pubic bone, splitting the muscle. Once discharged, his rehabilitation would have taken about four to six weeks at home. But, instead, the patient had his prostatectomy at the Prostate Cancer Center, which offers a minimally invasive approach using robotic-assisted laparascopy to remove early-stage prostate cancer tumors. He had six 1-centimeter incisions (less than half an inch each) and recovered relatively quickly following his surgery.
He is one of several early-stage prostate cancer patients who has benefited from robotic-assisted laparascopic surgery at Fairview-University. The technique, which makes use of the DaVinci™ robot, has a number of distinct advantages, says Kenneth Koeneman, MD, director of the Prostate Cancer Center at Fairview-University Medical Center. "The patients I have used this technique on have had great results," he says.
The procedure is specifically for early-stage prostate cancer patients who have smaller tumors. With the advent of prostate-specific antigen — a screening tool that identifies a protein specific to prostate cancer — physicians are able to earlier diagnose patients who have microscopic tumors.
"We're performing surgery on glands that look and feel normal on the outside, and that lends itself to doing minimally invasive techniques," says Koeneman. About 80 to 90 percent of the prostate cancer patients Koeneman sees have early-stage, organ-confined tumors.
Koeneman, who published a series of articles about laparascopic bladder surgery, says adding the DaVinci robot to the laparascopic process for prostate cancer has a number of advantages. For one, it improves the surgeon's ability to see the prostate gland, which normally lies behind the pubic bone. Sitting at a console, surgeons have three-dimensional vision and improved magnification to see smaller nerves. Better visualization can translate into less blood loss and improved continence for patients. The robot also acts as an extension of the surgeon's hands, reaching deep into the pelvis to an area the surgeon could otherwise not visualize. After the prostate is removed, the urinary channel is reconstructed by meticulous suturing.
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