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Robot-Assisted Prostate Surgery
procedures can be performed to save a life —
my life.
FIGURE 3. da Vinci surgical system operating
room setup.
The Options
There are many options that urologists
have at their disposal, though most of these
specialists prefer to use only one or two of
them in the treatment of their patients. One,
of course, is to wait and see. Prostate cancer is
usually a very slow growing type of cancer and
many times a man may die of some other age-related disease before the prostate cancer
could ever be fatal.
Standard surgical removal of the prostate
and seminal vesicles via the tried and true
open surgery method is also an option, though
the hospital recovery period is longer. Doctors
can also use laparoscopic methods wherein
smaller incisions are used to enter the body at
the site of the prostate, and handheld small
instruments are then inserted, along with a
light and vision system (fiber optic or television) to visualize,
manipulate, and cut and remove tissue. Robotic surgery is
similar to laparoscopic, but better control and magnification
is possible.
Radiation therapy — either implanted radioactive seeds
or external beam — to kill the cancerous tissue is another
method. Cryotherapy is used since it does kill the complete
prostate gland and any cancer cells, but it has some severe
side effects. Hormone therapy and chemotherapy are used
in many cases; a good friend of mine swears by his
treatments.
Your doctor will discuss these options with you and
may strongly suggest the method he/she prefers. My
doctor chose to completely remove my cancerous prostate
and the nearby seminal vesicles as my treatment option. If
you find yourself facing any sort of cancer possibility and
feel uncomfortable with the methods your doctor discusses,
of course, get a second opinion.
robot, but is a tele-robot controlled by a surgeon from a
nearby console (see Figure 2); as the title implies, it’s robot
assisted surgery. Figure 3 shows the general operating
room setup. My surgeon used the da Vinci “S” HD system,
though the hospital also had a newer da Vinci “Si” surgical
system.
Training to use the da Vinci system is getting easier.
Mimic Technologies is developing MScore — a portable
trainer device shown in Figure 4. As stated from MScore:
“The MScore system allows every movement and action the
<prospective> surgeon makes to be tracked and evaluated
within a virtual reality training environment. A surgeon’s
proficiency and score is established by utilizing a wide
variety of performance metrics, such as task time, efficiency
of instrument motion, blood loss, and the force applied to
FIGURE 4. Mimic Technologies
da Vinci trainer.
Robot-Assisted Prostate Surgery
Six years ago, I wrote an article for this column about
robotic surgery, having suspected a possibility of having
prostate cancer sometime in the future after my first biopsy
in 2002. I began looking at various options and quickly
settled on a robot-assisted prostatectomy as the best choice
for me. The choice was not made because of my robotics
background, but due to the less invasive method employed.
I found out that my present urologist (Dr. Michael Lipke)
had previously trained on the Intuitive Surgical da Vinci
system shown in Figure 1 and had performed hundreds of
successful prostate surgeries. Despite the terminology, the
da Vinci ‘robot’ is not a true intelligent or autonomous
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