Boston Medical Center was the first hospital in Massachusetts to perform robot-assisted surgery to treat prostate cancer and has consistently excellent outcomes.
Patient benefits may include:
- Reduced body trauma and pain
- Reduced blood loss and/or need for blood transfusions
- Reduced post-operative pain and/or discomfort
- Reduced hospital stay
- Excellent maintenance of continence and erectile function
The daVinci Robotic Surgical System allows our surgeons to perform complex minimally invasive procedures using a set of small incisions rather than a large incision. For example, a radical prostatectomy that in the past required a standard incision can now be performed with minor incision, greatly improving recovery time and patient comfort. Reports of cancer control, urinary control, and sexual function following robot-assisted radical prostatectomy are comparable to those following traditional open prostatectomy.
The 3-D stereoscopic view provided by the daVinci Surgical System allows our surgeons to more easily to identify vital anatomy (i.e. delicate nerves and blood vessels) while performing precise surgical dissections, and removing specific tissues. The robot's EndoWrist Instruments provide our surgeons with enhanced dexterity that is not always available using conventional laparoscopic or open procedure instruments.
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Frequently Asked Questions
What are the potential advantages of robotic prostatectomy?
Results with traditional open radical retropubic prostatectomy have steadily improved over time. At Boston Medical Center, we have completed more than 1,000 open prostatectomies through a mini-laparotomy incision, extending from the pubic bone upwards about half-way to the belly-button. Cancer control rates, and recovery of potency and continence are excellent in most patients. Our early experience with robotic prostatectomy suggests that these outcomes are at least equaled with robotic surgery, with less postoperative pain, reduced blood loss and a more rapid recovery for the patient. After robotic prostatectomy, patients are often walking and eating on the evening of the day of surgery, and are routinely discharged the next morning, after breakfast. The urinary catheter is removed after 7-10 days, and many patients return to work shortly thereafter.
What are the potential drawbacks of robotic prostatectomy?
At Boston Medical Center we have had excellent long term results with regard to cancer control, potency and continence recovery following traditional open prostatectomy. It is clear now from several studies that successful outcomes after prostate cancer surgery are directly related to the skill of the surgeon, including the specific techniques utilized and the volume of cases performed. Robotic technology allows surgeons skilled in open prostatectomy to perform the same operation utilizing minimally invasive techniques. Prostate cancer surgeons who have demonstrated excellent cancer control and quality of life outcomes in their patients can use the daVinci robot system to translate these excellent results into their patients operated using this minimally invasive technology. However, the daVinci system will not automatically improve the outcomes of less experienced surgeons. At Boston Medical Center, we have learned that proper patient selection is important in achieving excellent outcomes. Not every patient is a good candidate for robotic prostatectomy and currently 20% of our patients, after a comprehensive evaluation, are recommended to undergo the standard open radical retropubic approach.
Who are good candidates for robotic prostatectomy?
Patients who are of normal weight, without extensive prior abdominal surgery or radiation therapy, and with a less extensive cancer burden in the prostate are considered strong candidates for robotically assisted prostate surgery. However, even patients who don’t meet those criteria have good options for treatment of localized prostate cancer. We try and tailor treatment for each individual patient that matches each unique circumstance. A consultation with a Boston Medical Center urologist can help you determine if you are a candidate for robotic prostatectomy.