The New Frontier
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Surgical removal of the prostate and surrounding tissue (radical prostatectomy) has long been recognized as one of the most effective forms of therapy for prostate cancer. A conventional radical prostatectomy involves an open incision across the abdomen. Laparoscopic prostatectomy represents a major advance in the treatment of prostate cancer by offering men a less-invasive alternative to traditional surgery.
Now, physicians at the Vattikuti Urology Institute are entering the next generation of prostate surgery by performing robotic laparoscopic prostatectomy. Mani Menon, M.D., director of the Vattikuti Urology Institute, developed the robotic technique called VIP (Vattikuti Institute Prostatectomy). Under Dr. Menon's direction, urologists at the Vattikuti Urology Institute are among the first in the world to perform prostatectomy using the daVinci™ computer-enhanced minimally invasive surgery system.
About the Robotic Laprascopic Procedure
This is the Institute's preferred procedure for removal of the prostate. The operation is performed by a team of surgeons led by Menon and James Peabody, M. D.
With the state-of-the-art daVinci™ system, the surgeon uses a three-dimensional computer vision system to manipulate robotic arms. These robotic arms hold special surgical instruments that are inserted into the abdomen through tiny incisions. A laparoscope - a long, thin, lighted telescope - is inserted through one incision and connected to the computer monitor that allows the surgeon to see inside the body.
The three-dimensional view helps the surgeon more easily find the delicate nerves and muscles surrounding the prostate. The robotic arms can rotate a full 360 degrees, allowing the surgeon to manipulate surgical instruments with greater precision and flexibility.
The surgeon performs the same nerve-sparing procedure done in conventional laparoscopic prostatectomy, but with greater precision. The prostate, nearby lymph nodes, seminal vesicles and adjacent tissue are removed through the small incisions, which are closed with a few stitches.
The operation sometimes involves removing the lymph nodes that drain the prostate. This depends upon the specific pathology of the cancer, the PSA level and the digital rectal examination. In addition to removing the prostate, seminal vesicles also are removed. Men can no longer able to father children following the procedure.
If the lymph nodes appear to be cancerous at the time of surgery, the operation usually is terminated because cancer in the lymph nodes indicates that the cancer is outside the prostate. Removing the prostate will not cure the cancer once the cancer has spread outside the prostate.
If the lymph nodes appear normal, surgery is completed. Patients usually are discharged in 24 hours and return to normal activity in one week.
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Mindfully.org note: We were alerted to this surgical technology in the advertising of a theatre program—amongst the advertising of plastic surgeons for the rich, diamonds, and high-end furniture. It appears that even surgeons are striving to be machines. But if we don't quit this mad dependence on technology soon, it won't be possible for us to live without it. And we mean that quite literally. In the long run, it is the technology that is killing us. |
After the operation, patients have a Foley catheter to drain the bladder. When the prostate is removed, the bladder has to be connected to the urinary channel within the penis. The catheter helps protect the connection during the healing process. In most patients, the catheter will be removed in 4-5 days, but there is a small chance that it will have to be reinserted because of temporary swelling at the connection site.
With the robotic technology, surgeons manipulate instruments with greater precision and flexibility, leading to a more rapid recuperation and return to normal function for most patients. Patients begin walking the evening of surgery and begin a diet one day after surgery.
To qualify for this type of surgery, patients must be free of other significant health complications and be within a fairly normal weight range.
sources: http://www.henryford.com/body.cfm?id=39855 and http://www.intuitivesurgical.com 15jun03
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