Robotic vs Traditional Prostate Cancer Surgery
So, how is robotic surgery different from open surgery for prostate cancer? Traditionally, open surgery has been used to treat the patients that have prostate cancer. An incision is made and the prostate is removed with an open surgical technique that allows physicians to actually feel the prostate gland, take the gland out and then sew the bladder down to the urethra. About 10 years ago, robotic surgery entered the treatment realm for prostate cancer and using the robot, we have been able to be more precise in doing our dissection and also allowing the bladder and the urethra to be sewn back together in a much more precision fashion. Now, robotic surgery offers three advantages that I believe to the patient. Number one, the surgeon can see things much-much better.
Everything is magnified. It is on a TV camera and the surgeon is looking down into a small space and they can see the blood vessels and all the structures down in the pelvis extremely well. Secondly, the blood loss from this procedure is dramatically less than what we see with open surgery. Traditionally, blood loss from open surgery is about a liter of blood between 800 and 1 liter of blood. In robotic surgery, the average blood loss is about 150 to 200 cc, so the risk of transfusion with robotic surgery is significantly less and then thirdly, the real benefit of robotic surgery is the patients are able to leave the hospital quickly. Typically, with an open prostatectomy, patients would stay in the hospital for one to three days and they have a catheter left in place anywhere from 5 days to 10 days. With robotic surgery, the catheters typically stay in place for one week, in some cases even shorter and traditionally, the patients are released from the hospital on the following day after surgery.
Some prostate cancers are high risk, aggressive, and more likely to spread. Others are low risk, least likely to have bad outcomes. The biopsy says cancer, but current diagnostic tools provide limited information about how aggressive a man's individual disease is, so most men decide to treat prostrate cancer immediately.
Once treated, many men experience serious long-term side effects like incontinence and sexual impotence. Immediate treatment is not always needed, but right now a man can't be sure if his cancer is the kind that is likely to require treatment or if he is okay to wait for now. What if there was a test that could determine how aggressive prostate cancer is. Genomic health is developing a new test to do just that.
By reviewing the underlying biology of the tumor and using genes from multiple biologic pathways, the test can predict the aggressiveness of prostate cancer when diagnosed, allowing a man to make a more informed treatment decision with confidence, taking care of himself with more information and greater peace of mind.
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