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Abraham, this is what robotic surgery looks like. The surgeon is on the right at the console. The robot is merely a mechanical extension of his skill set:


Depending upon the procedure, I think I'd want robotic surgery too, if it were available. As far as the cost goes, until they enter greater use and more and more procedures can be adapted to their use, the amortization costs will be steep per procedure.

Back when I was working in the ER, CAT Scan machines were brand new technology. You actually had to have permission from the federal government to have one installed in your hospital because they were still a rare resource, and the feds wanted to make sure that they were strategically allocated around the country so that everyone would be able to access one if necessary. The hospital I worked for—Huntington Memorial Hospital in Pasadena, California—specialized in neurosurgery and thoracic surgery, and was a level 1 trauma center, so we had a CAT Scanner early on, and not too long afterwards, we also had one of the first MRI machines in the country. Nowadays, you can't hardly swing a dead cat without hitting an office that has its own CAT and MRI scanners. Consequently, the price of a scan can be negotiated downward for cash. But I don't think we're there yet with robotic machines.

Rotor,

"The robot does not do the surgery. The surgeon manipulates the robot" - so to me it rather appears like an evolved variation on a theme of laparoscopic surgery. Sorta...

This information gives me a much better idea of how this is done along with the photo TAM provided.

SewTexas,

Was the procedure a success or is it still to early to certain?

(and if that's too personal a question, please feel free/comfortable about not responding)

a couple of comments on this thread: I had a robotic surgery last year. Briefly, they punched 4 holes in my left side underneath the rib cage. Went through chest up to left side of neck. Took a biopsy of a small "mass" that showed hot after a scan. Turns out it was just extra thyroid tissue and not a problem. It took about a week to get back to normal activities. No telling how long recovery would have been had they cracked me open. Biggest problem was getting one of the holes to quit draining.
other comment: Not everyone that has a RP is incontinent afterwards. Also, a good urologist can help with function. I know folks that have had the Retropubic Radical Prostatectomy and folks that have had the RP via robotics. The robotic surgery is definitely the way to go. Recovery time and physical trauma is substantially less than traditional surgery.
last comment: Guys, man up; go get the digital exam AND the PSA. Once a year if over 40yo. Sooner if a family history exists.

Abraham wrote:Rotor,

"The robot does not do the surgery. The surgeon manipulates the robot" - so to me it rather appears like an evolved variation on a theme of laparoscopic surgery. Sorta...

This information gives me a much better idea of how this is done along with the photo TAM provided.

SewTexas,

Was the procedure a success or is it still to early to certain?

(and if that's too personal a question, please feel free/comfortable about not responding)

Exactly, it is robotically assisted laparosocopic surgery and it makes it possible for a surgeon to do much more than he could do with conventional laparoscopy, seated at a console working comfortably and all in 3D. All still controlled by the surgeon.

I had a robotic prostectomy in September of '09. Very little pain and super fast recovery. The worst thing was the gas they put into your abdomen to make room for the equipment. It took days for all that to pass.

Abraham wrote:Rotor,

"The robot does not do the surgery. The surgeon manipulates the robot" - so to me it rather appears like an evolved variation on a theme of laparoscopic surgery. Sorta...

This information gives me a much better idea of how this is done along with the photo TAM provided.

SewTexas,

Was the procedure a success or is it still to early to certain?

(and if that's too personal a question, please feel free/comfortable about not responding)

Abraham,

At his 6 week check his PSA was 0, we are actually going in for his 6 month check tomorrow. So yes, they got all of the cancer.

The Annoyed Man wrote:

rotor wrote:Radical prostatectomy can either be done as an open procedure or as a less invasive robotic procedure. If it were me, I would go with the small scars and out patient surgery. There is always a risk of some incontinence with any of these procedures. I don't think the risk is lower with an open procedure. I have never heard of a neurosurgeon doing a prostatectomy. I have talked to some of my ENT friends that now say they are doing some oral cancers that they would never have touched before the robot (and now are getting better results) and would have just referred to radiation or chemo . I know they are doing some cardiac bypass grafts using the robot. It is possible for a very experienced surgeon to be in Dallas supervising a less experienced surgeon for example in Alaska doing a case similtaneously. The potential is huge. Some cases just don't need the assistance of the robot. It is a very expensive toy. For those select cases though where it really makes a difference I want an experienced robotic surgeon, an experienced OR crew (essential), and an insurance company that won't deny payment.

rotor wrote:With the right surgeon, for the right procedure, with the right operating crew it beats an open procedure every time. If any of those criteria are not met than forget it. The trick of course is to find out which facility can meet those criteria. If I ever need a radical prostate it will be done with the aid of the robot.

I have a benign prostatic tumor which gives me problems. My urologist is a typical early adopter of new technologies. At my last visit to him, I asked, why can't I just have this thing cut out and be done with it using robotic surgery? His answer is that, even with robotic surgery, the location of the tumor on the anterior aspect of the prostate would mean almost certain loss of continence and "function".

Robotic surgery can be a great thing. Look Ma! No shaky hands! But it isn't the answer to ALL surgical questions. I've elected to continue treating my condition medically rather than surgically.

TAM: "Yeah, uh, doc? I seem to be annoyed all da time..."
Doc: "well, let's schedule that colonoscopy and we'll see what's causing that..."

rotor wrote:

Abraham wrote:GlockDude26,

Your surgery was robotic?

Not trying to be a smart-aleck, but you're post doesn't come right out and say so...

The thing I've yet to see addressed is what percentage of the surgery being performed robotically is, if I may generalize, 10% / 20% / 90% or...? Does a surgeon do the initial cut and then let the robot take over or how does this work...?

Also, I've yet to read anything negative about robotic surgery.

Have there been instances of things going horrifically wrong with this type surgery or is it so rare as to be negligible?

The surgeon places instruments into the body cavity via small incisions and also a video camera. He then sits at a 3d module and manipulates those instruments with both hands while watching in 3d. There are many videos on youtube demonstrating this. The robot does not do the surgery. The surgeon manipulates the robot. How well the operation goes depends upon the skill of the surgeon and the crew, not the robot. As in any surgery things can go wrong but in most cases if things go wrong you are back to having it done the old fashioned way. Please get it out of your head that a robot is doing the surgery. This is robotic assisted surgery done by a surgeon. Pick one that has lots of experience.

sorry must have misread the question...what rotor said is how mine went.

SewTexas wrote:

Abraham wrote:Rotor,

"The robot does not do the surgery. The surgeon manipulates the robot" - so to me it rather appears like an evolved variation on a theme of laparoscopic surgery. Sorta...

This information gives me a much better idea of how this is done along with the photo TAM provided.

SewTexas,

Was the procedure a success or is it still to early to certain?

(and if that's too personal a question, please feel free/comfortable about not responding)

Abraham,

At his 6 week check his PSA was 0, we are actually going in for his 6 month check tomorrow. So yes, they got all of the cancer.

and his 6 month check up was 0!!!! yes!!!!