Robotic Prostatectomy Surgery Raises Patient Optimism

Patients undergoing robotic prostatectomy surgery for the treatment of prostate cancer are more optimistic than those who choose traditional surgery for the removal of their cancerous prostate, according to new research published in The Journal of Urology. Most robotic surgery patients surveyed anticipated shorter hospital stays and faster return to physical pursuits, including sexual activity.

Dr. Samadi, Vice Chairman, Department of Urology, and Chief of Robotics and Minimally Invasive Surgery at The Mount Sinai Medical Center, is cautious regarding men’s faith in robotic prostatectomy surgery. “While, I believe the heightened sense of optimism felt by men facing robotic prostatectomy surgery is a testament to success achievable by the procedure,” he says, “It is important to recognize that the robot itself does not impart a positive outcome, but the experience of the involved surgeon is of great importance.”

The study, conducted via questionnaire out of Duke University, consisted of less than 200 men of comparable age and PSA level. Slightly more than half of the participants underwent robotic prostatectomy surgery, while the other half opted for traditional, open prostatectomy surgery. The majority of the men who chose robotic surgery predicted overall faster recovery, including shorter return time to sexual potency. Researchers report that resumption of physical activity and sexual potency was not conclusively faster.

While the post-operative reports indicate robotic prostatectomy patients were released from the hospital 8-12 hours sooner than their traditional surgery counterparts, there was inconclusive evidence on the robotic surgical benefits related to physical activity and sexual functioning. The study was designed as a follow-up to a previous report. At that time, the authors found that patients were less satisfied after robotic surgery as compared to those who had open surgery. They hypothesized that patients undergoing robotic surgery had falsely-elevated expectations. Researchers hypothesized that some of this was due to extensive marketing promoting robotic prostatectomy surgery. This study took a critical look at the importance of educating patients. “As a surgeon, my job is to balance patient hopes with realistic, educated expectations. For some of the patients in this study, it appears that expectations were not properly managed by their surgeons,” commented Dr. Samadi.

“Patient education and managing patient expectations are important issues in treating prostate cancer. Robotic prostatectomy surgery offers advantages over traditional surgery, but that does not mean recovery is easy. Men must be given a clear understanding of the benefits of the procedure and the challenges of prostate cancer recovery,” stressed Dr. Samadi.

Robotic prostatectomy surgery, also referred to as Robotic Assisted Laparoscopic Prostatectomy (RALP), is a minimally invasive procedure during which a surgeon-guided robot removes the cancerous prostate through tiny keyhole incisions, resulting in less blood loss. Dr. Samadi uses his own SMART Surgery (Samadi Modified Advanced Robotic Technique) version of RALP, pairing the robot’s precision with his distinct technique and extensive experience. As a result, there is less damage to the neurovascular bundle and his patients receive excellent recovery rates for prostate cancer cure, sexual potency, and urinary continence.

Much of the success of robotic surgery depends on surgeon expertise, gained only through actual surgical experience

Dr. Samadi agreed, “It is absolutely true that the more robotic prostatectomy procedures a surgeon performs, the greater their skill level. This is a challenge the medical community has always faced. Surgeons need patients to build experience and patients need experienced surgeons.” Some see the superior outcomes accomplished by a particular robotic surgeon and expect the same from any surgeon. Unfortunately, not all surgeons have the same level experience.

Experts often caution men against becoming part of the robotic surgery learning curve. “Men deserve the very best in surgical care and prostate cancer treatment,” added Dr. Samadi, “That level of expertise is available today. Once a man chooses robotic prostatectomy surgery, he need only do the research to find the right highly-skilled surgeon.”