Treatment of Prostate Cancer

Approximately 30 percent of prostate cancer patients in the U.S. are treated with surgery.

The surgery is called a radical prostatectomy and there are three methods: open surgery where a large incision approximately 4 to 6 inches is made in the abdomen and two minimally invasive types — laparoscopic and robotic-assisted laparoscopic, also known as da Vinci Prostatectomy.

What is a Radical 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.¹

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 to 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.

• The da Vinci Prostatectomy (see below) 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.

da Vinci Prostatectomy

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.²

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.

da Vinci Prostatectomy also offers these potential benefits:

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

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

Surgical practices that will be utilizing the da Vinci robot for radical prostacetomy include the urological practices of Dennis LaRock, MD, of Urology Inc. in Fall River, and Derek Hausladen, MD, of Hawthorn Medical Associates in North Dartmouth.

Footnotes

1. The National Prostate Cancer Coalition: www.fightprostatecancer.org home > treatment & research > treatment options > surgery. 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.

2. 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 da Vinci website for additional clinical support.

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

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