Prostate Problem Guide
Robotic Prostate Surgery - The da Vinci System
For many patients suffering from early prostate cancer the recommended treatment will be surgery in the form or a prostatectomy, either performed using traditional open surgery or minimally invasive laparoscopic surgery. Both forms of surgery can be extremely effective, as long as cancer is confined to the prostate gland, but can leave patients with a loss of sexual function as a result of damage caused to nerves, muscles and other tissue around the area of the prostate.
A new surgical system designed to solve this problem is the da Vinci system manufactured by Intuitive Surgical Inc. of Sunnyvale California. In essence the da Vinci system is laparoscopic surgery using robotic technology.
The da Vinci system consists of a patient-side cart which stands next to the operating table and which has three or four robotic arms (the number depends upon the form of surgery being performed) which hold a high resolution 3D endoscope (connected to state-of-the-art image processing equipment providing high quality images of the operating area) and the necessary operating instruments. The patient-side cart is supervised by a skilled surgeon who will make the necessary access incisions for the operation and also supervise the laparoscopic arms, for example, changing instruments as required.
A second, again highly skilled, surgeon will then sit at the surgeon's console which is located to one side of the operating theatre. Sitting comfortably the surgeon is able to view a 3D image of the operating area and uses his own hands to manipulate the robotic operating arms of the patient-side cart.
Unlike laparoscopic surgery in which the surgical instruments are both difficult to manipulate and have a limited range of movement, robotic prostate surgery allows the surgeon to rotate the surgical instruments through a full 360 degrees of movement in a natural manner, very much as he would in traditional open surgery.
Unlike open surgery however the surgeon also has the ability to greatly magnify the area that he is working on and to "scale" the movement on instruments so that he can make extremely small and very precise movements with the operating instruments. This also permits the surgeon to eliminate the "tremor" which is sometimes a problem. One great advantage of this is that it allows older surgeons who have perhaps lost some of their dexterity to return to the operating theatre bringing with them many years of surgical experience.
Robotic prostate surgery using the da Vinci system combines the best of both worlds, allowing surgeons to operate naturally as they do with open surgery and combining this with all of the benefits of minimally invasive surgery seen in laparoscopic surgery.