[music] Prostatectomy remains the most common form of therapy for prostate cancer. The advantage
of robotic is more of an improvement in getting better and quicker. In general, doing a prostatectomy,
a minimally invasive approach offers the benefit of less blood loss, which is big, and a quicker
patient recovery are two of the major things that are really a benefit.
A patient it usually in the hospital after a minimally invasive prostatectomy for one
or two, maybe three, nights depending on their clinical course, as opposed to doing it through
a bigger incisions where it could easily be four or five nights.
They can do more strenuous activity quicker; there’s less chance of hernias and wound
problems and things like that. And so overall there’s just a quicker recovery over the
standard incision approach. Where an incision is made from about the umbilicus until the
pubic bone and the then incision is the muscle is spread and the prostate and bladder exposed.
And so you end up with an incision about the length of your hand. Whereas with minimally
invasive prostatectomy, depending on how it’s done, laparoscopically or robotically, you
end up with four or five pen hole or keyhole incisions. And then one small incision to
extract the prostate and that’s usually at the umbilicus; overall, the incision is
much much less.
So the advantage of doing it robotic is it’s much more comfortable and natural for the
surgeon and the reason why is because the surgeon is able to manipulate the robotic
arms inside the human body in much the same way that he would move his own hands, in fact,
it’s exactly the way you would move your own hands. And so it’s a very intuitive
procedure in terms of the motion of your hands and the motion of the instruments; it allows
you to accomplish a lot more with a lot less strain. So that’s the real advantage to
the surgeon of robotic surgery; it allows us to do more precise and complicated movements
much easier. The robot only does exactly what we do with our own hands; it mimics every
movement up to the smallest detail. So we set at a console just a few feet away from
the surgical bed and our head is in a view box and we see in 3D in the view box, and
that’s an advantage of doing it robotically; you have excellent vision even compared to
laparoscopic, which has good vision with magnification. With the robot you have magnification and
3D. So you have depth perception.
So anytime you remove the prostate gland or whatever approach it may be, there are several
side effects or risks that can happen. The very well known one is erectile dysfunction.
The other one is incontinence. And then there can also be just general complications such
as bleeding or infection. What we found with the robotic approach or laparoscopic approach
is that the risk of bleeding obviously is much much less. But overall, the other complications
such as erectile dysfunction and incontinence are essentially the same, if not a little
bit better than by doing it via open approach. And so that is one thing we are always focus
on and just to make sure that what we’re doing is at least equal and hopefully better
and in most cases it is better than the open approach. And in terms of cancer cure rates,
the use of the robot of laparoscopic surgery has been shown to at least be equal once again
in terms of cure rates and in most situations, better in many studies better than the open
approach in terms of cure of cancer.
It’s already a very common approach for good reason and I think in the future it will
just continue to be refined. We’re also starting to move toward doing these really
minimally invasive prostatectomy’s where you may not even hardly be able to see a scar
at all after we’re done. And we would just go through one small incision at the umbilicus
and so that’s something that we’re working on and I think in the future will also be
a possibility.