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Robotic surgery

Robotic surgical procedures


Prostate Cancer & Treatment

The prostate is a male reproductive gland that produces a fluid found in semen. Located below the bladder and in front of the rectum, the prostate surrounds the urethra - the tube that empties urine from the bladder.

Prostate cancer affects the prostate gland and may spread to surrounding structures. While most men with prostate cancer have no symptoms, physician can find prostate cancer during a regular checkup, using a combination of a blood test called a PSA and a digital rectal exam (DRE).

Nearly one in six American men will be diagnosed with prostate cancer during his lifetime.1 With greater awareness, prostate cancer detection is on the rise and mortality is declining. Moreover, better treatments are allowing more men to return to active and productive lives after treatment.

Treatment Options

If you have an early diagnosis of prostate cancer, there is usually a range of treatment options. These may include conservative management, radiation therapy with either external bream or brachytherapy therapy, cryosurgery and prostatectomy - surgical removal of the prostate. Your treatment options will depend on a number of factors, including the stage of the disease, your age and health or personal preference.

Prostatectomy

The gold standard treatment option for men under 70 with early-stage, organ-confined cancer is surgical removal of the prostate using nerve-sparing radical prostatectomy. Prostatectomy is also the most widely used treatment for prostate cancer today in the US.2

The primary goal of prostatectomy is removal of the cancer. A secondary goal is to preserve urinary function and - when applicable - erectile function. Preservation of the nerves necessary for erections can be an extremely important goal for patients. These nerves run alongside the prostate and are often damaged when removing the prostate. A nerve-sparing prostatectomy attempts to preserve these nerves so that the patient may be able to return to his prior erectile function.

Types of Prostatectomy

Approaches to this procedure include traditional open surgery, conventional laparoscopic surgery or da Vinci Prostatectomy, which is a robot-assisted laparoscopic surgery.

With a traditional open procedure, your surgeon uses an 8-10 inch incision to access the prostate. This approach often results in substantial blood loss, a lengthy, uncomfortable recovery and a risk of impotence and incontinence.

Conventional laparoscopy uses a specialized surgical camera and rigid instruments to access and remove the prostate using a series of small incisions. This approach provides your surgeon with better visualization than an open approach. In addition, it provides patients the benefits of a minimally invasive procedure.

Despite these advantages, conventional laparoscopy relies on rigid instruments and standard 2D video, technical limitations that can be challenging for the surgeon. Because of these drawbacks, conventional laparoscopy doesn’t lend itself well to complex procedures like prostatectomy. Therefore, very few urologists use this approach for prostatectomy. Moreover, neither laparoscopy nor open surgery can provide adequate visualization for a very precise, nerve-sparing prostatectomy.

daVinci Prostatectomy (dVP)

Referred to by many as robotic surgery for prostate cancer or robotic prostatectomy, da Vinci Prostatectomy is more accurately a robot-assisted, minimally invasive surgery that is quickly becoming the preferred treatment for removal of the prostate following early diagnosis of prostate cancer. In fact, studies suggest that da Vinci Prostatectomy may be the most effective, least invasive prostate surgery performed today.3

Though any diagnosis of cancer can be traumatic, the good news is that if your doctor recommends prostate surgery, the cancer was probably caught early. And, with da Vinci Prostatectomy, the likelihood of a complete recovery from prostate cancer without long-term side effects is, for most patients, better than it has ever been.

da Vinci Prostatectomy is performed with the assistance of the da Vinci Surgical System - the latest evolution in robotics technology. The da Vinci Surgical System enables surgeons to operate with unmatched precision and control using only a few small incisions. Recent studies suggest that da Vinci Prostatectomy may offer improved cancer control and a faster return to potency and continence.3 da Vinci Prostatectomy also offers these potential benefits:

  • Significantly less pain
  • Less blood loss
  • Fewer complications
  • Less scarring
  • A shorter hospital stay
  • And a faster return to normal daily activities

If you are a candidate for prostate surgery, talk to a Resurrection Medical Center surgeon who performs da Vinci Prostatectomy.

While clinical studies support the effectiveness of the da Vinci System when used in minimally invasive surgery, individual results may vary. Surgery with the da Vinci Surgical System may not be appropriate for every individual. Always ask your doctor about all treatment options, as well as their risks and benefits.

For additional information on minimally invasive surgery with the da Vinci Surgical System visit www.davincisurgery.com.

References

  1. The National Prostate Cancer Coalition. home > treatment & research > treatment options > surgery
  2. The National Prostate Cancer Coalition. home > treatment & research > treatment options > surgery
  3. Most effective minimally invasive surgery in terms of cancer control, potency and continence, cancer control being defined in part by margin rates and PSA test scores. The following studies provide support for da Vinci Prostatectomy's effectiveness in these three areas: Ahlering TE, Woo D, Eichel L, Lee DI, Edwards R, Skarecky DW. Robot-assisted versus open radical prostatectomy: a comparison of one surgeon's outcomes. Urology. 2004 May;63(5):819-22. Menon M, Tewari A, Peabody JO, Shrivastava A, Kaul S, Bhandari A, Hemal AK. Vattikuti Institute prostatectomy, a technique of robotic radical prostatectomy for management of localized carcinoma of the prostate: experience of over 1100 cases. Urol Clin North Am. 2004 Nov;31(4):701-17. Tewari A, Srivasatava A, Menon M; Members of the VIP Team. A prospective comparison of radical retropubic and robot-assisted prostatectomy: experience in one institution. BJU Int. 2003 Aug;92(3):205-10. Please also see the Clinical References section of the site for additional clinical support.

 

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Uterine Conditions & Treatment

When a woman faces a medical condition that affects her uterus, the hollow, muscular organ that holds and feeds a fertilized egg, the emotional impact can often be as challenging as the physical. These conditions include, but are not limited to, cervical and uterine cancers such as endometrial cancer, uterine fibroids, uterine prolapse, excessive bleeding and endometriosis.

Treatment options are as varied as the conditions themselves, depending on individual circumstances. A woman's age, health history, surgical history and diagnosis (benign or cancerous), all factor into the recommended course of action.

Endometriosis, also known as endometrial hyperplasia, is a condition in which the endometrial tissue grows outside the uterus, causing scarring, pain, and heavy bleeding. It can often damaging the fallopian tubes and ovaries in the process. A common organic cause of infertility, endometriosis can be treated with medications such as lupron for endometriosis that lowers hormone levels and decreases endometrial growths. While such medications often relieve associated symptoms, a patient should understand the potential side effects before pursuing this treatment regimen.

For endometrial cancer, also known as uterine cancer and more common among women after menopause, standard treatment options include hormone therapy, radiation therapy, chemotherapy and hysterectomy (surgical removal of the uterus). Three of these - radiation therapy, chemotherapy and hysterectomy - are also used to treat cervical cancer.

For benign (non-cancerous) conditions like menorrhagia (heavy menstrual bleeding), non-surgical treatments like hormone therapy or minimally invasive ablative therapies may offer relief. For fibroids, uterine-preserving myomectomy - a surgical alternative to hysterectomy - may be an option.

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Hysterectomy

For most uterine conditions, if available non-surgical treatments fail to relieve symptoms, many women choose a more certain result with elective hysterectomy. Each year in the U.S. alone, doctors perform about 600,000 hysterectomies, making it the second most common surgical procedure.1

While symptoms such as chronic pain and bleeding often point a woman and her doctor toward hysterectomy as the preferred treatment choice, life-threatening conditions such as cancer or uncontrollable bleeding in the uterus often necessitate a hysterectomy and follow-up treatment.

While hysterectomy is relatively safe, always ask your doctor about all treatment options, as well as their risks and benefits, to determine which approach is right for you. And if hysterectomy is recommended or required, you owe it to yourself to learn about da Vinci Hysterectomy, a robot-assisted, minimally invasive surgery that for many women has potential as the safest and most effective treatment available.

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Fibroids & Treatment Options

Uterine fibroids* are benign (non-cancerous) tumors occurring in at least one quarter of all women.2 They can grow underneath the uterine lining, inside the uterine wall, or outside the uterus.

Many women don't feel any symptoms with uterine tumors or fibroids. But for others, these fibroids can cause excessive menstrual bleeding (also called menorrhagia), abnormal periods, uterine bleeding, pain, discomfort, frequent urination and infertility.3

Treatments include uterine fibroid embolization - which shrinks the tumor - and surgery. Surgical treatment for uterine tumors most often involves the surgeon removing the entire uterus, via hysterectomy.4

While hysterectomy is a proven way to resolve fibroids, it may not be the best surgical treatment for every woman. If, for example, you hope to later become pregnant, you may want to consider alternatives to hysterectomy like myomectomy. Myomectomy is a uterine-preserving procedure performed to remove uterine fibroids.

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Types of Myomectomy

Each year, roughly 65,000 myomectomies are performed in the U.S.5 The conventional approach to myomectomy is open surgery, through a large abdominal incision.6 After cutting around and removing each uterine fibroid, the surgeon must carefully repair the uterine wall to minimize potential uterine bleeding, infection and scarring. Proper repair is also critical to reducing the risk of uterine rupture during future pregnancies. Menorrhagia is extensive menstrual bleeding.

While myomectomy is also performed laparoscopically, this approach can be challenging for the surgeon, and may compromise results compared to open surgery.7 Laparoscopic myomectomies often take longer than open abdominal myomectomies, and up to 28% are converted during surgery to an open abdominal incision.8

A new category of minimally invasive myomectomy, da Vinci Myomectomy, combines the best of open and laparoscopic surgery. With the assistance of the da Vinci Surgical System - the latest evolution in robotics technology - surgeons may remove uterine fibroids through small incisions with unmatched precision and control.

* Uterine fibroids are also called fibroids, uterine tumors, leiomyomata (singular - leiomyoma) and myomas or myomata (singular - myoma).

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da Vinci Hysterectomy

If your doctor recommends hysterectomy, you may be a candidate for da Vinci Hysterectomy, one of the most effective, least invasive treatment options for a range of uterine conditions. da Vinci Hysterectomy is performed using the da Vinci Surgical System, which enables surgeons to perform with unmatched precision and control - using only a few small incisions.

For most patients, da Vinci Hysterectomy can offer numerous potential benefits over traditional approaches to vaginal, laparoscopic or open abdominal hysterectomy, particularly when performing more challenging procedures like radical hysterectomy for gynecologic cancer. Potential benefits include:

  • Significantly less pain
  • Less blood loss
  • Fewer complications
  • Less scarring
  • A shorter hospital stay
  • A faster return to normal daily activities

Moreover, da Vinci provides the surgeon with a superior surgical tool for dissection and removal of lymph nodes during cancer operations, as compared to traditional open or minimally invasive approaches.9 da Vinci Hysterectomy also allows your surgeon better visualization of anatomy, which is especially critical when working around delicate and confined structures like the bladder. This means that surgeons have a distinct advantage when performing a complex, radical hysterectomy involving adhesions from prior pelvic surgery or non-localized cancer, or an abdominal hysterectomy.10

As with any surgery, these benefits cannot be guaranteed, as surgery is both patient- and procedure-specific. While radical hysterectomy or abdominal hysterectomy performed using the da Vinci Surgical System are considered safe and effective, these procedures may not be appropriate for every individual. Always ask your doctor about all treatment options, as well as their risks and benefits.

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Learn More

If you are a candidate for hysterectomy, talk to a Resurrection Medical Center gynecologist or gynecologic oncologist (a cancer specialist) who performs da Vinci Hysterectomy.

While clinical studies support the effectiveness of the da Vinci System when used in minimally invasive surgery, individual results may vary. Surgery with the da Vinci Surgical System may not be appropriate for every individual. Always ask your doctor about all treatment options, as well as their risks and benefits.

For additional information on minimally invasive surgery with the da Vinci Surgical System visit www.davincisurgery.com.

References

  1. Center for Disease Control. Keshavarz H, Hillis S, Kieke B, Marchbanks P. Hysterectomy Surveillance - United States, 1994-1999. Morbidity and Mortality Weekly Report. Surveillance Summaries. July 12, 2002. Vol. 51 / SS-5. Page 1. www.cdc.gov/mmwr/PDF/ss/ss5105.pdf
  2. Newbold RR, DiAugustine RP, Risinger JI, Everitt JI, Walmer DK, Parrott EC, Dixon D. Advances in uterine leiomyoma research: conference overview, summary, and future research recommendations. Environ Health Perspect. 2000 Oct;108 Suppl 5:769-73. Review.
  3. National Institutes of Health: Fast Facts about Uterine Fibroids.
  4. Becker ER, Spalding J, DuChane J, Horowitz IR. Inpatient surgical treatment patterns for patients with uterine fibroids in the United States, 1998-2002. J Natl Med Assoc. 2005 Oct;97(10):1336-42.
  5. Lumsden MA.Embolization versus myomectomy versus hysterectomy: Which is best, when? Hum Reprod. 2002; 17:253-259. Review.
  6. Becker ER, Spalding J, DuChane J, Horowitz IR. Inpatient surgical treatment patterns for patients with uterine fibroids in the United States, 1998-2002. J Natl Med Assoc. 2005 Oct;97(10):1336-42.
  7. Kristen A. Wolanske, MD; Roy L. Gordon, MD. Uterine Artery Embolization: Where Does it Stand in the Management of Uterine Leiomyomas? Part 2. Appl Radiol 33(10):18-25, 2004. Medscape.10/27/2004.
  8. Advincula AP, Song A, Burke W, Reynolds RK. Preliminary experience with robot-assisted laparoscopic myomectomy. J Am Assoc Gynecol Laparosc. 2004 Nov;11(4):511-8.
  9. Boggess JF. da Vinci® Hysterectomy for Endometrial Cancer with Staging. Presented at ISI WWSSM 1/06. 871391_rev B_dVH Endometrial Cancer Presentation
  10. UNC Department of Obstetric & Gynecology Health & Healing in the Triangle Vol 8 No 3 pp 22-23.

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Gastric Bypass

If your doctor recommends surgery to control your weight, you may be a candidate
for da Vinci Gastric Bypass, potentially the most effective, least invasive option
for weight loss surgery. da Vinci Gastric Bypass allows surgeons to provide the gold
standard treatment,1 using only a few small incisions.

Open Surgical Incision vs da Vinci® Gastric Bypass

da Vinci Gastric Bypass offers the potential for better outcomes than with open or
laparoscopic approaches. This is because da Vinci provides surgeons with superior visualization, dexterity,
control and ergonomics required for this technically demanding operation. da Vinci allows surgeons to operate
on higher-BMI patients; it can result in shorter procedures times and may offer reduced risk for serious complications
by providing surgeons with superior visualization and instrumentation. 2

As with any surgery, these benefits cannot be guaranteed, as surgery is both patient- and procedure-specific.
While da Vinci Gastric Bypass is considered safe and effective, it may not be appropriate for every individual.
Always ask your doctor about all treatment options, as well as their risks and benefits.

For additional information on minimally invasive surgery with the da Vinci Surgical System visit www.davincisurgery.com.

References

  1. Johnson W, Demaria E. Surgical treatment of obesity. Curr Treat Options Gastroenterol. 2006 Apr;9(2):167-74.
  2. Jacobsen G, Berger R, Horgan S. The role of robotic surgery in morbid obesity. J Laparoendosc Adv Surg Tech A. 2003 Aug;13(4):279-83. Review.

While clinical studies support the effectiveness of the da Vinci® System when used in minimally invasive surgery, individual results may vary. Surgery with the da Vinci Surgical System may not be appropriate for every individual. Always ask your doctor about all treatment options, as well as their risks and benefits.

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