Robotic equipment gives prostate patients a less painful option

[bluemoon24]

According to urologist Pankaj Kalra, prostate cancer is a disease in which malignant, cancerous cells form in the tissues of the prostate.



"One of six American men will be diagnosed with prostate cancer in his lifetime," said Kalra. "New advances in medical technology are enabling cancer victims to go on to live active and productive lives after their treatment."



Kalra said that one of the most common treatments for prostate cancer involves the surgical removal of the prostate gland, a procedure known as radical prostatectomy.



"Traditional radical prostatectomy requires a large, 8- to 10-inch incision near the stomach," he said. This open surgery commonly results in substantial blood loss, a lengthy and uncomfortable recovery and the risk of impotence and incontinence, he said.



"With The da Vinci prostatectomy, patients have smaller incisions and less scarring, less pain and risk of infection, less blood loss and transfusions, a faster recovery and shorter hospital stay, and an immediate return to normal activities," Kalra said.



When Phoenixville Hospital patients are diagnosed with prostate cancer, they are given several options, including radiation, regular surgery and now the da Vinci prostatectomy.



"Patients can have the new surgery done within one month," Kalra said. "They have to get checked out by their regular physician, and provide one unit of blood to be stored just in case. With the traditional surgery, there is a 10 percent rate of transfusion, and with the new surgery, the percentage rate of transfusion is down to 1 to 2 percent."



The da Vinci Surgical System, which carries a $1.5 million price tag, consists of an ergonomic surgeons console, a patient-side cart with four interactive robotic arms, a high-performance vision system, and proprietary finger/wrist instruments.



Powered by state-of-the-art robotic technology, the system allows the surgeons hand movements to be scaled, filtered and translated into precise movements of micro-instruments within the operative site.



The surgeon sits at a high-resolution, 3-D stereo viewer, and is able to see the target anatomy at high magnification, brilliant color and with natural depth of field.



While at the viewer, the surgeon uses the consoles master controls to maneuver the patient-side carts four robotic arms. One of the arms has a high-magnification endoscopic camera attached to it. The jointed-wrist design of the controls exceeds the natural range of motion of the human hand, along with motion scaling and tremor reduction.



The system enhances surgical capabilities by enabling the performance of complex surgeries, such as The da Vinci prostatectomy, through a total of five tiny surgical openings. Kalra said the robotic arms go into the stomach, which has been inflated, approximately 7 to 8 inches.



"While three of the arms are used for the surgery, the fourth arm has a camera attached," he said.



During the surgery, there are two surgeons present, along with two nurses, an anesthesiologist, and a circulating nurse. While one surgeon is working the robotic arms at the console, the other surgeon is stationed close to the patient during surgery.



Both Kalra and Dr. Jose Moreno are trained to perform The da Vinci prostatectomy, which consists of removing the prostate gland, and then a catheter is used to reattach the bladder and the urine channel.



Kalra said that the system cannot be programmed, nor can it make decisions on its own.



"It requires that every surgical maneuver be performed with direct input from the surgeon," he said. "As soon as you lift your head away from the viewer, the robotic arms automatically stop. They wont move on their own."



Kalra said that while the console and patient are usually in the same operating room, there have been advancements to where a surgeon can work the console while the patient is thousands of miles away.



"There have been some of these surgeries performed on those who are serving in the military," he said.



The first da Vinci Surgical System was introduced in 1999, and in 2000 it became the first robotic surgical platform commercially available in the United States to be cleared by the Food & Drug Administration for use in general laparoscopic surgery. There are just 300 systems installed in hospitals worldwide.



The first surgery in Phoenix-ville Hospital using the system was in mid-November, said Kalra.



"I feel we are lucky to have one here," he said. "The advancement in technology is ongoing and we are glad to have this system here."



Kaynak: SağlıkHaber