October 14, 2008
Live Webcast of Endopelvic Fascia Sparing Robotic Prostatectomy Performed By David B. Samadi, M.D.
"There's simply no question that robotic prostate surgery is the future and I was so happy to answer questions and share my expertise with cancer patients and doctors who are curious about the procedure," said Dr. David Samadi on hosting his live webcast about endopelvic fascia sparing robotic surgery on OR-Live.com, August 13, 2008. The webcast was moderated by Simon Hall, MD, who is Chair of the Department of Urology and Director of the Barbara and Maurice A. Deane Prostate Health and Research Center at Mount Sinai. David Samadi, MD, is Chief of Robotics and Minimally Invasive Surgery at Mount Sinai. At the start of the webcast, Dr. Simon Hall remarked, "This is a very exciting time in urology because of what robotic technology has made possible -- it's enabled unprecedented advancements."
Dr. Samadi uses the da Vinci S HD Surgical System designed by Intuitive Surgical. He's insistent that robotic technology makes a marked difference in patients' quality of life after a prostatectomy because the patient retains potency and continence, which is not always the case with open or traditional surgery. Removing the cancer is not the only goal anymore, which makes a significant difference in people's lives. "Patients want to be cancer-free, they want to have sexual function and they want to be continent," says Samadi.
Although the robotic technology is state-of-the-art, the experience of the surgeon is an important factor in positive outcomes. The technology acts as an expert assistant with the doctor present throughout, conducting every step of the surgery. Dr. Samadi has performed over 1,500 robotic prostatectomies and, on average, performs 10 to 15 robotic surgeries per week. He is also trained in open and laparoscopic surgery and brings these techniques to bear, when useful, during robotic operations. As he says, "I'm 3 surgeons in one head."
Dr. Samadi's robotic prostate removal requires only five small "keyhole" incisions in the patient's abdomen, through which delicate instruments are inserted along with a camera that shows magnified images from inside the body onto a screen. The da Vinci surgery system creates 3D representations and filters and scales the surgeon's hand movements, making them more precise than has ever been possible.
The smaller incisions mean far less blood loss in comparison to open surgery, where the incision must be between 7 and 10 inches long, in order to remove a small, walnut-sized organ. As a point of comparison, blood loss during open surgery is typically 500-700 cc, during laparoscopic it's 300-400 cc and for robotic surgeries, 50-100 cc, which is the equivalent of a few tablespoons.
Robotic surgery reduces the duration of the prostatectomy to 1 to 2 hours. In the open procedure, the surgery takes 2.5-3.5 hours, and for a laparoscopic operation, it's 3.5-4.5 hours. Most patients are discharged from the hospital within 24 hours of robotic surgery instead of the 2 to 4 days required of patients undergoing open and laparoscopic procedures.
Samadi summed up the benefits of robotic prostate surgery with his "Rule of Ones," that demonstrates the benefits of robotic surgery technology:
-- Surgery is approximately ONE hour -- Hospital stay is only ONE day -- Catheter for just ONE week -- Recovery is ONE month
Because robotic surgery is more precise than the pre-existing prostate cancer treatment techniques, positive margin rates are lower for patients who have had robotic operations. Surgical margin rates measure the risk of cancer recurrence, making a low positive margin percentage what a surgeon seeks. The overall positive margin rate at Mount Sinai is 6.6%.
At the end of the OR-Live webcast, after live questions were fielded and answered by both Doctors Samadi and Hall and case video had been discussed, Dr. Samadi said this in conclusion: "There is no greater joy as a surgeon than to look at your patient and say you're cured, your PSA (prostate-specific antigen) is undetectable and you can move on."
About David B. Samadi
David B. Samadi, MD, is a board-certified urologic surgeon trained in open, laparoscopic, and robotic surgery. He is one of the world's most experienced da Vinci surgeons with a professionally acknowledged level of success. Dr. Samadi is one of the only surgeons in the country to have completed two fellowships: one in oncology at Memorial Sloan Kettering Cancer Center in New York, and the other in laparoscopy at Henri Mondor Hospital in France.
Dr. Samadi has completed more than 1,500 da Vinci cases in his career, and since his arrival at Mt. Sinai a year ago, he has performed nearly 600 robotic operations. Dr. Samadi has proctored and taught urologists across the world how to perform the endopelvic fascia sparing robotic prostatectomy procedure. Dr. Samadi's robotic surgery program at Mount Sinai is unique in its ability to combine the advanced technology of robotics with the expertise of open and laparoscopic skills.
To contact Dr. Samadi, please call 1-888-Robot10 (1-888-762-6810), or visit his website: www.roboticoncology.com.
About Simon J. Hall
Simon J. Hall, MD, is chairman of Mount Sinai's Department of Urology and Director of the Barbara and Maurice Deane Prostate Health and Research Center at Mount Sinai School of Medicine. For information about Dr. Hall's expertise please contact him at 212-241-3743.
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David B. Samadi, MD 1-888-Robot10 (1-888-762-6810) www.roboticoncology.com Simon J. Hall, MD 212-241-3743