While the da Vinci technology allows for the precise translation of the surgeon's movements while eliminating any tremor present in all surgeons’ hands it does not provide tactile feedback. As surgeons however, we rely on tactile sensation only when we do not have an accurate or clear view of the operative field. The camera system utilized with the da Vinci system is a clear 3 dimensional field with ten times the magnification of even the surgeon with 20-20 vision.

A radical robotic prostatectomy incorporates the advantages offered with laparoscopy together with the delicate maneuvers and techniques previously only available with open surgery. Standard laparoscopic instruments can be cumbersome and do not avail themselves to delicate surgical procedures. Minimally invasive robotic radical prostatectomy allows the surgeon to perform sensationally an "open" radical prostatectomy without the need for the large incision.

bull;Greater surgical precision, which, in turn, potentially means more accurate removal of cancer and reduced risk of impotence and incontinence

Impotence and/or incontinence are possible side effects. The degree of sexual function is determined by the man's age, how sexually active he was before the procedure and how much the surgical procedure affects the nerves. Newer procedures are currently being investigated in some major medical centers that may spare the nerves during the procedure, thus preserving sexual potency.

Diagnosis of prostate cancer can, understandably, be an emotional and difficult experience for many patients. Your fears, concerns, questions, and opinions are welcomed and valued as part of your treatment. Communication with Dr. Gholami and the office staff is recommended to maintain rapid recovery. Support groups may also prove helpful in dealing with frustrations and other feelings associated with cancer.

Bladder capacity is usually reduced somewhat by the surgery, but the main cause is that, after surgery; the bladder wall is swollen and thickened and irritable. Normally, the bladder wall is thin and elastic and maintains a low pressure until it has stored 8 to 10 ounces of urine. After surgery, the swollen bladder does not store much urine at a low pressure. As soon as it starts to fill, the pressure goes up and you feel the need to urinate.

A radical prostatectomy is the complete removal of the prostate and seminal vesicles. The radical prostatectomy may be performed using a retropubic (midline incision) or perineally (incision between the anus and scrotum). In the modem era, the overwhelming majority of surgeons prefer the retropubic route. Radical prostatectomy may also be performed laparoscopically.

The actual procedure normally takes 1 ½ to 2 hours, although unusual circumstances could increase the time required. Yes, general anesthesia is required. Robotic prostatectomy offers many advantages compared to conventional surgery, but it is nevertheless a major operation.

One benefit of this procedure is minimal loss of blood, so you will not have to donate your own blood to have on hand for transfusion.

It is not possible to say for certain where the recurrent cancer is located, but there is about a 70% chance that it is in the “bed of the prostate” (where the prostate used to be). Accordingly, radiotherapy has a good chance of controlling it. After the prostate gland has been completely removed, any PSA in the blood is produced by prostate cancer cells that have left the prostate gland and spread to other areas of the body.

With any cancer, not only prostate cancer, there’s always a possibility that the cancer can come back and that’s why patients need to have follow up visits. I recommend a PSA test every six months for 15 years after the operation.

Yes, nerve sparing radical prostatectomy was started in the early 1980's. I have been performing this operation since 1984 with very rewarding results.

Radical Prostatectomy is the complete surgical removal of the prostate and seminal vesicles for control of prostate cancer. The laparoscopic operation is performed through several incisions in the abdomen measuring 1/4 - 1/2 inch in length. Specially designed surgical instruments and cameras afford the surgeon precise control and excellent visibility for performing the operation.

The radical retropubic prostatectomy is currently the most widely performed operation for prostate cancer in the United States. This is performed through a single incision of 5 to 10 inches in length in the lower abdomen. The surgery done inside the body on the prostate is essentially the same in both operations. With laparoscopic surgery, however, the single larger incision is not required.

Patients generally have significantly less pain, are well enough to leave the hospital sooner, and experience less blood loss than patients who undergo the "open" radical prostatectomy. They also generally can safely return to normal physical activity several weeks sooner with the laparoscopic operation. Many men also are able to have their catheter removed after surgery sooner than usual after the open radical prostatectomy.

A very few number of surgeons have developed an expertise in the laparoscopic or robotic approach. Any claims of superiority of the laparoscopic or robotic approach are absolutely unfounded. The primary goal of radical prostatectomy is to cure the cancer. There is evidence laparoscopic procedures leave cancer behind. There is not a shred of evidence that continence or potency is better with a laparoscopic radical prostatectomy.

If your doctor recommends surgery to treat your prostate cancer, you may be a candidate for robotic prostatectomy. This new, less-invasive surgical procedure utilizes a state-of-the-art surgical system that helps your surgeon see vital anatomical structures more clearly and to perform a more precise surgical procedure.

The two treatment options are postoperative radiotherapy, which should begin before the PSA rises above 1.0ng/ml, and intermittent or continuous hormonal therapy, which can be initiated immediately or delayed until the PSA rises to 4.0.

This swelling could be related to lymph node dissection, which sometimes causes swelling in the groin, penis, scrotum, and pubic area. In such circumstances, I recommend a visit to the surgeon and perhaps a CT scan of the abdomen and pelvic region.

Radical prostatectomy is a very challenging surgical procedure even for those experts who specialize in treating genitourinary cancers. Outcomes following radical prostatectomy are directly linked to the experience of the surgeon. It is imperative to ask the surgeon "how many procedures they perform?" For those individuals who are seeking their care in the State of New York, Health Share is a web site that provides data on all urologic surgeons. Over the last five years, Dr.

Radical prostatectomy is the usual surgical option for early prostate cancer. It involves having a general anaestetic and staying in hospital for approximately 6 days. You will be infertile afterwards and may have temporary incontinence and impotence, which is often treatable. The operation may be followed up with radiotherapy or hormone therapy to deal with any remaining cancer cells.

Robotic prostatectomy requires only dime-sized incisions, and patients usually recover within 2-3 weeks, whereas traditional prostate surgery requires a 6-8 inch incision, and recovery may take a month or longer.

Robotic radical prostatectomy does not effect sensation or the ability to have an orgasm, but may limit the ability to have an erection. If a nerve-sparing procedure can be performed, approximately 70 ? 75% of potent men under the age of 65 recover the ability to have sexual intercourse following robotic radical prostatectomy.

Most men will need to wear some kind of incontinence pad for a few weeks or months following robotic prostatectomy. About 50% of men are continent within 3 months, and 95% are continent within 1 year from the time of surgery.

The main limitation of robotic surgery is a lack of tactile sensation. However, in most cases this does not affect the outcome of surgery since it is nearly impossible to feel the difference between cancerous and benign tissue.

Usually, the patient is in the hospital for 2 to 3 days. The catheter remains for 10 days. The patient can drive once the catheter is out. No vigorous exercise should be performed for 6 weeks. The patient can return to work after 3 or 4 weeks, but he usually tires easily because of anemia for the first 6-8 weeks.

IMRT (Intensity-Modulated Radiation Therapy) is one of the best forms of radiation therapy. It is computer-controlled radiation that delivers precise doses to malignant tumors or specific areas within a tumor with minimal effect on other tissue. The technology allows for higher and more effective doses to be delivered without damaging surrounding tissue. But there is a statistical issue about how the results are reported that make them appear 10% to 20% better than they really are.

Most patients go home two to three days after surgery. The use of epidural analgesia (or intravenous Toradal) for pain relief allows most patients to get up out of bed the night of their surgery. Any drain other than the Foley catheter is usually removed prior to leaving the hospital.

Radical prostatectomy and radiation therapy have the potential to cure only those cancers that have not spread beyond the prostate gland. The primary advantage of radical prostatectomy is that it totally removes the prostate and virtually guarantees that those cancers confined to the organ are cured. Between 70-80% of men who undergo radical prostatectomy for prostate cancer are cured by surgery alone.