Then
and
NOW
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Robot-Assisted
Prostate Surgery
by Tom Carroll
FIGURE 1. Intuitive Surgical da Vinci robot.
74 SERVO 04.2012
FIGURE 2. Michael Lipke, MD at the console of
the da Vinci system.
Cancer! That’s a word we all dread to hear,
whether about someone we know or especially
concerning ourselves. I heard that word spoken to
me early last year after I had a prostate biopsy.
Needless to say, thousands of things were
spinning through my mind. I knew that prostate
cancer is the second most common cancer among
men worldwide, with one in six men here in the
US diagnosed with the disease. Another scary fact
is that prostate cancer is the second leading cause
of cancer deaths among US men. The good news
is if the cancer is discovered early, there is a much
greater chance of curing prostate cancer. “What is
the next step?” I asked my doctor, as I was aware
that there were many options available to men
with this condition.
As a reader of a robotics magazine, I’d like to take you on a trip into an operating room with a robot performing surgery on a person: me.
Before discussing robot-assisted prostate surgery, I’d like to go back a bit
to my first prostate biopsy back in 2002. Understanding prostate health is
important in understanding the need for any sort of treatment option. I
had a PSA (prostate specific antigen) blood test score of 4. 7 and it had
been slowly rising from 3. 2 to 3. 4 in the late 1990s. My family practice
doctor was concerned and sent me to a urologist. With data in hand, my
urologist performed the needle biopsies and he found no cancer. Yes, the
days waiting after the biopsy until he told me the ‘good’ results were not
days that I enjoyed. Nine years later and a new doctor, my PSA had risen
to 11.95 and another needle biopsy was necessary.
There has been much speculation about the need for a PSA test
recently, and even some doctors raised concern that the test could
actually be harmful since a few patients have incurred severe infections
from the biopsy procedure. Some patients have been rushed into
surgery only to find tiny scattered cells that would not have grown into
tumors for years. I happen to be in the majority who believe in these
tests and the subsequent biopsies. The needle biopsies are not
enjoyable but can discover a cancer situation where subsequent surgical
