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Robotic Surgery - The Next Generation has Truly Improved upon Open Surgery
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 It is our pleasure to inform you about an exciting new technology available at St. Josephs Hospital. We have been using the Da Vinci robotic system to perform radical prostatectomies for prostate cancer. The Da Vinci robotic system allows us to access the prostate via laparoscopic ports and perform detailed surgery using state-of-the-art machinery. The device incorporates two surgical arms and a 3-D camera system that affords 10X magnification. Robotic operating arms and powerful magnification enable easier access to the prostate, allowing for a more precise dissection. Precision is crucial when performing a nerve sparing prostatectomy in order to preserve post-operation potency. Also, the anastamosis of the bladder and urethra can now be done under direct visualization. This allows for a faster return to continence. Our patients have been recovering faster with shorter hospital stays. The average return to work has been 1.5 weeks compared to 4-6 weeks after a standard prostatectomy. Additionally, blood loss and the need for transfusion have been reduced as a result of the high magnification and ease of access to the prostate.
Renal surgery can also be achieved through laparoscopic ports similar to gallbladder surgery. It is performed using laparoscopy and hand assisted technology. Laparoscopic renal surgery results in less scarring and quicker return to normal activities than standard renal surgery.
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Does the robot do the surgery?
No, the surgeon does the operation. The robot is an instrument that allows the surgeon to operate in small spaces in the body. It essentially makes the surgeon's hands two seven millimeter instruments.
How is the prostate removed?
One of the operating port sites is used to remove the prostate, usually the one at the umbilicus.
Is a nerve sparing prostatectomy possible?
Yes, this is where the robot performs best. The surgeon has the benefit of 10X magnification and the fine delicate instrumentation to perform the precise removal of the nerve bundles off the prostate.
Will I be incontinent of urine (i.e. wear a diaper) after surgery?
The majority of men are continent after the procedure. Thus far we have achieved a 100% continence rate. However, there is no guarantee of continence. There is always a risk of incontinence following prostate surgery. The robotic technique simply allows a much better anastamosis of the bladder and urethra after the prostate is removed, permitting improved healing and a quicker return to continence post surgery.
How much pain will I be in?
Since the surgery is done through a small incision, most patients experience much less post procedure pain then with open surgery. Patients tend to need much less pain medication. After one week, most are feeling no pain at all. Also, there is a decreased risk of post-operative hernias.
How long will I have to have the catheter in after surgery?
Less than one week. A drain is left in after the procedure which may be taken out 2-3 days later.
When can I exercise?
Light walking is encouraged right after the procedure. After 2 weeks, jogging and aerobic exercise is permitted. After four weeks, heavy lifting can resume.
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Robotic Surgery Advantages
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- Better chance of potency after nerve sparing radical prostatectomy
- Advanced robotic technology increases operational standards
- Decreased hospital stay (1 or 2 days)
- Decreased need for post-surgery narcotics
- Less blood loss
- Increased technical precision
- Quicker constinence
- Smaller, less obvious incision
- Precise urethral anastamosis
- Quicker recovery
- Extraperitoneal surgery allows rapid recovery
- Accelerated return to normal activities
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