Currently, we are studying this question. However, other studies have shown that return of continence and potency may take up to two years. Dr. Hu and other surgeons who offer this procedure feel the 10x magnification of the camera lens, decreased blood loss and fine, precise movements of the robotic instrumentation contribute to nerve sparing that is equal to or better than open surgery. Again, more study is needed to confirm this.
Early in a surgeon’s experience, it takes time to become accustomed to relying on visual cues rather than feel or tactile sensation that is used in open surgery. Again, surgeon experience is the most important factor. Furthermore, the da Vinci robot is a tool that helps the surgeon perform the same steps that are required in open surgery.
In rare instances, severe medical problems prevent patients from tolerating general anesthesia and being able to undergo robotic prostatectomy. However, previous hernia repairs, abdominal or prostate surgery are not contraindications to robotic prostatectomy.
Robotic surgery has also been used to remove the bladder to cure bladder cancer or radical cystectomy. In addition, some kidney cancers can be treated with this approach.
In approximately 300 cases, Dr. Hu has observed a technical problem with the robot on one occasion. In this instance, it was necessary to complete the case laparoscopically. No conversions to open surgery have taken place in his experience.
Men should avoid strenuous activity and use common sense: if it hurts, don't do it. Furthermore, some men are constipated after surgery due to effects of general anesthesia and transabdominal laparoscopic surgery. It is recommended that you stay on a clear liquid or soft diet until the first bowel movement after surgery.
Patients commonly ask urologists what their risks of incontinence and impotence are following surgery. A study by Dr. Litwin showed that continence and potency rates reported by healthcare providers differ from that obtained from validated instruments such as the UCLA Prostate Cancer Index or the Expanded Prostate Cancer Index Composite. Furthermore, a recent paper by Dr. Spencer and Dr. Miller suggest that measuring continence and potency following treatment for prostate cancer with validated quality of life instruments are indicators of quality of care.
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