General FAQs - Dr. David B. Samadi
Frequently asked questions related to prostate cancer

What is Prostate Cancer?

La próstata es una glándula del tamaño de una nuez ubicada delante del recto, por debajo de la vejiga y rodea la uretra. Su objetivo principal es producir el líquido que transporta los espermatozoides durante el orgasmo masculino. De acuerdo con estimaciones recientes, hay entre 180.000 y 200.000 nuevos casos diagnosticados de cáncer de próstata detectados anualmente.

El cáncer de próstata es la segunda causa principal de muerte por cáncer en los hombres después del cáncer de pulmón. En los EE.UU., aproximadamente 40.000 hombres mueren como resultado de cáncer de próstata cada año. El cáncer de próstata se caracteriza por el crecimiento incontrolado y el potencial de propagación de las células anormales.

What is Robotic Radical Prostatectomy?

This procedure is also called da Vinci robotic prostatectomy. It is a minimally invasive surgical removal of the prostate involving the latest advancements in robotics and computer technology.

It is a computer-enhanced minimally invasive surgical system consisting of three components:

  • Surgeon Console
  • Patient-side Cart
  • Insite Vision System

The Surgeon Console consists of the master controls the surgeon uses in order to manipulate the Patient-side Cart and the EndoWrist instruments. The surgeon’s hand movements are translated to the EndoWrists through the surgeon console. The instruments only move if the surgeon decides to move them. The robot is not in control of the instruments — the surgeon is.

The Insite Vision System provides a 3-D view of the surgical field – a vast improvement over the 2-D view of laparoscopic surgery. This translates to a much better visual field and better depth perception. The high definition video cameras give a 10X to 15X magnification - a view the surgeon could never get with traditional surgery. This is particularly important in visualization of the prostate capsule, sparing the neurovascular bundles responsible for erectile function and reconnecting the urethra to the bladder.

What are some of the available surgical treatments for prostate cancer

Hay tres opciones quirúrgicas para extirpar toda la glándula prostática. Estas opciones son para pacientes con cáncer de próstata confinado al órgano principios diagnosticado.

  • Robótica prostatectomía radical
  • Prostatectomía radical laparoscópica
  • Prostatectomía radical abierta tradicional

Am I a good candidate for a da Vinci robotic prostatectomy?

Men who are diagnosed with a localized prostate cancer are candidates for this procedure. Most patients who are candidates for open surgery would have an excellent outcome with this procedure. The indications for this surgery are very similar to open surgery.

Does the da Vinci prostatectomy robot perform the operation?

Absolutely not! The robot is completely under the control of the surgeon. The robotic arms enable the surgeon to operate in small spaces in the abdomen.

What if the da Vinci Robot fails during the surgery?

Only once in the past three years has that happened to Dr. Samadi. He was able to complete the case laparoscopically without needing to open the patient’s abdomen. For this reason, it is important to be skilled in open, laparoscopic and robotic surgery.

How long will I have the catheter after the surgery?

The catheter is removed seven days after the surgery.

How long does the da Vinci Robotic Prostatectomy take?

Typically it takes 2½ to 3 hours depending on the size of the prostate, the patient's anatomy and constitution, and the extent of surgery. This is comparable to the average time of open surgery.

What is a laparoscopic radical prostatectomy?

Laparoscopic radical prostatectomy is a minimally invasive surgical treatment for prostate cancer. It involves a few key hole incisions in order to remove the entire prostate.

What is radical retropubic prostatectomy?

Radical retropubic prostatectomy is the surgical removal of prostate, seminal vesicles and vas deferens through a lower abdominal incision. The incision measures 8 to 10 inches in length.

What are some of the advantages of laparoscopic radical prostatectomy?

  • Shortened hospital stay (read patient testimonials).
  • Significantly less bleeding.
  • Early removal of catheter.
  • Minimal requirement for pain medications after the surgery.
  • 10X to 15X visual magnification.
  • Resumption of normal activity within one to two weeks after operation.
  • Cosmetically more acceptable.

How does a laparoscopic radical prostatectomy compare to open as far as the cancer cure rate?

The results of cancer control in both laparoscopic and open radical prostatectomy patients is essentially identical. This is confirmed in major institutions across the country where this procedure is being performed on a routine basis.

¿Cuál es la duración del procedimiento?

How long do I stay in the hospital?

The majority of patients are discharged the day after surgery. However, the time of discharge is decided on a case-by-case basis. By the second night, over 90 percent of patients are comfortable enough to go home.

How long do I need to have a catheter after the laparoscopic radical prostatectomy?

For open surgery, the catheter is removed after two to three weeks. However, with a laparoscopic prostatectomy, the catheter is removed seven days after the operation. This is done in our office guided by X-ray to ensure the urethra is properly connected to the bladder.

What is the blood loss for this procedure?

The average blood loss for this procedure is about 150cc, significantly reducing the risk of blood transfusion.

Are the nerves responsible for sexual function being spared during this procedure?

Every effort is made to spare the nerves. One of the main advantages of this procedure is the fact that the nerves and vessels are all magnified and it is much easier to save them. Return of potency could take up to six months and, in some individual cases, Viagra has helped the patients.

Am I going to leak after a laparoscopic radical prostatectomy?

For the first few weeks, one needs to wear a protective pad. The return of continence is fast and, within a few weeks, over 95 percent of the patients have full control of their urination. An occasional patient exhibits mild stress urinary incontinence after surgery which is usually resolved by performing Kegel exercises.

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