At Alabama Urology and Robotic Center, PC (AURC), we are proud to have developed a top notch robotic surgery program in a relatively short time frame. We completed our first twenty cases in one of the fastest time periods in the southeast. We continue to be a high volume center, performing as many as three cases per week, which has been shown to enhance patient outcomes and care. Furthermore, due to our previous experience with many types of minimally invasive procedures and camera-based operations, we have been able to expand the benefits of robotics surgery to not only men with prostate cancer, but also for women and children. We are one of only a handful of private practice urological groups that has a single surgeon with such a expansive robotic surgical procedure list.
Prostate cancer is the second most common cancer of men and will affect approximately sixty percent in their lifetime. One of of every six men will be affected by prostate cancer but thanks to early screening and excellent treatment options, most affected men, when diagnosed early on, will experience a complete cure from prostate cancer. The most common treatment for prostate cancer is radical prostatectomy or complete surgical removal of the prostate gland and robotic prostatectomy is increasing becoming the surgery of choice due to its benefits.
When one considers robotic surgical benchmarks such as set-up time, operative time and positive margin rates for prostatectomy, we at AURC have been able to exceed all of these. We also maintain an active database of all our robotic prostatectomies so that we can monitor our patients' surgical outcome.
Specifically, we are most proud of our surgical positive margin rate when performing radical prostatectomies for prostate cancer. If one looks at published medical data, they will find a typical positive margin rate of 20-30% for a surgeon's first 30 cases. Our current positive margin rate is a low 3%. We have been able to accomplish this while maintaining our standard indications for a desirable nerve-sparing prostatectomy. Onwards from our first procedure, we are also seeing a faster return of normal erectile function and continence with robotic prostatectomy as compared to our open procedures. When choosing a robotic surgeon, patients should consider that some surgeons who convert to robotic surgery purposely sacrifice nerve tissue in order to assure they do not have positive margins while learning how to perform robotic prostatectomy. We at AURC did not have to follow this normal trend, due to our experience, training, and preparation. We currently perform nerve sparing robotic prostatectomy on the majority of our patients.
What is robotic surgery?
The surgery is performed with the surgeon who is seated comfortably a few feet away from the patient at a control console, while his assistant stands by the operative table. Surgery is performed through tiny incisions. Unlike standard laparoscopic surgery, the robotic instruments have wrist-like maneuverability, allowing the surgeon to move them like his own hand with increased dexterity unequaled with either open or standard laparoscopic surgical approaches.
A radical prostatectomy via the da Vinci Robotic Surgical System is a minimally invasive technique with enhanced precision and visualization. Advantages of this method to patients include reduced pain, shorter hospital stays, and a faster recovery. When performed by experienced robotic surgeons, these advantages are accompanied by excellent rates of cancer control, urinary control, and sexual potency that are comparable or superior to conventional open surgery.
What are benefits of robotic surgery?
- Decreased blood loss
- Shortened length of hospital stay
- Decreased postoperative pain
- Less scarring
- Better Cosmetic Outcome
- Shorter urinary catheter time
- Faster return to regular activities
- Anticipation of improved potency and continence
What types of surgeries has AURC performed with this robotic technique?
We are one of only a few centers that has individual surgeons who are trained to utilize robotic surgery for male, female, and pediatric patients. We typically perform 2 or 3 robotic procedures per week. Due to our extensive experience with other types of laparoscopic procedures and minimal invasive surgeries, we have been able to utilize the da Vinci system for the following conditions and surgeries.
da Vinci Robotic System Overview
The Surgeon Console: The surgeon operates while seated comfortable at a three dimensional computer system viewing a 3-D image of the surgical field. The surgeon's fingers grasp the master controls and wrists naturally positioned relative to his or her eyes. The technology seamlessly translates the surgeons hand, wrist and finger movements into precise, real-time movements of the surgical instruments inside the patient.
The Patient Cart: The cart provides the four robotic arms that execute the surgeon's commands. The robotic arms pivot 360 degrees to enhance range of motion and minimizing tissue damage.
EndoWrist™ Instruments: A full range of instruments are provided to support the surgeon while operating. The instruments are designed with seven degrees of motion that mimic the dexterity of the human hand and wrist. Each Instrument has a specific surgical mission such as clamping, suturing and tissue manipulation and they can be quickly changed as the surgeon needs.
The Visual Cart and Camera: This component provides the true to life 3-D images of the operative field. The surgical field and operating images are enhanced, magnified and refined to optimize visualization of vital structures. The camera can be brought within 1-2 cm of structures unlike open operations and this unparalleled vision is credited for increasing the outcomes with robotic surgery.
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