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June 25, 2008 > Robotic Technology Gives Surgeon the Edge in Prostate Removal

Robotic Technology Gives Surgeon the Edge in Prostate Removal

Patients Benefit from Shorter Hospital Stay, Less Recovery Time

When a diagnosis of prostate cancer is confirmed, the question becomes how to treat it. After CP Kung was diagnosed with prostate cancer a few months ago, the 42-year-old hardware engineer from Fremont discovered that there were several treatment options for his condition.

"When I discussed treatment options with my urologist, minimally invasive surgery was the most attractive option because it offered the fastest recovery time," he says.

For Mr. Kung and other men in the Tri-City area facing complete removal of their prostate for treatment of prostate cancer, it's important to know that there is a less invasive option available locally through Washington Hospital's Institute for Minimally Invasive and Robotic Surgery.

So what does minimally invasive really mean? In short, it means a procedure that could get you home from surgery as soon as lunch the day after surgery.

Typically, the surgery to remove the prostate, known as a radical prostatectomy, involves the surgeon making an incision "from the belly button to the pubic bone," according to Washington Township Medical Group urologist Dr. Mark Saleh, M.D., F.R.C.S.C. (Certified by the American Board of Urology and Fellow of the Royal College of Surgeons of Canada.) Then, once the prostate has been removed, the bladder is reattached to the urethra.


Quicker recovery

However, employing the minimally invasive procedure, using a robotic surgical system, called da Vinci(r), Dr. Saleh is able to perform the same operation laparoscopically via three or four tiny incisions rather than one large one.
The result? By enabling Dr. Saleh to operate using smaller incisions, the technology has the potential to reduce a patient's hospital stay and recovery time, as well as decrease post-operative pain.

"This means the patient can leave the hospital the following day after surgery rather than two to three days with traditional open surgery," Dr. Saleh says. "Even better, in many cases, the recovery and return time to work is cut in half."

After undergoing a robotic-assisted prostatectomy performed by Dr. Saleh on May 29, Mr. Kung spent one night at the hospital before returning home to his family.
"I'm very happy with how the surgery turned out," says Kung. "I was able to return home and start my recovery process quite quickly and I'm healing really well."
The robotic surgery system allows Dr. Saleh to operate with the advantage of a 3-D camera, which provides him with depth perception as he operates using robotic arms. The arms not only allow him increased range of motion more flexible than the human wrist, but the arms also minimize natural tremors of even the steadiest of hands.

Additionally, the technology provides optimal magnification of the surgical site providing better acuity - by 15 times - than the human eye is capable of achieving.


The future of surgery

"Minimally Invasive Robotic Surgery truly represents the future of surgery, but even the most advanced equipment is only as good as the surgeons using it," according to Dr. Ramsey Araj, general surgeon and medical director for the Institute of Minimally Invasive and Robotic Surgery. "Advances in robotic surgery have allowed our highly trained surgeons at Washington Hospital to operate with unmatched surgical precision using the smallest possible incisions, with our goal being a better overall experience for our patients. Fortunately, as the technology continues to expand, we have increased the variety of surgical options available to the community."

On average, the recovery time at home for an open surgery prostatectomy is between four to six weeks; whereas, recovery from a robotic prostatectomy could take as little as two weeks.

The good news is that, if caught early enough, many men facing removal of the prostate could benefit from this particular type of surgery.

"Any patient that would qualify for a radical prostatectomy is a potential candidate for the minimally invasive procedure," according to Saleh.
However, he notes that some patients may need open surgery based on their individual medical histories, including previous surgical procedures. Therefore, he recommends discussing all possibilities with a surgeon.


Equivalent results, added benefits

"The main benefits of minimally invasive surgery include a shorter hospital stay, quicker recovery, and less pain," Dr. Saleh emphasizes. "The effectiveness of the surgeries (open versus minimally invasive) is equivalent. Additionally, our ability to perform the surgery while simultaneously preserving the nerve tissue - which could theoretically improve the chances of preserving a patient's ability for an erection - is at least as good as open surgery and there could be an argument for it being better.

"In the right hands, you're going to have the same result as far as cancer control with either the minimally invasive or open surgery for a prostatectomy."
Another important benefit of the minimally invasive surgery is its potential to reduce the amount of time patients need a catheter - one week compared to two or three with open surgery.

This means patients get back to work - or their golf game - as fast as possible after surgery.


Cancer Free

Nearly a month after his surgery, Mr. Kung is cancer free and he's in very good spirits. "I have a good prognosis and I'm very happy," he says. "Dr. Saleh monitors my progress once a week and I'm taking everything one step at a time."


Get the facts

"It is important for patients to understand their options before undergoing a major surgery," according to Dr. Araj. "If you are a candidate, it is always advisable to see how minimally invasive surgery could make the difference in your particular case."

To learn more about the procedures performed at Washington's Institute for Minimally Invasive and Robotic Surgery, visit www.whhs.com, click on "Services & Programs" and select "Institute for Minimally Invasive and Robotic Surgery" from the drop-down menu.

To search for a local urologist by name, location and languages spoken, visit www.whhs.com and click on "Find a Physician."

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