US university surgeon demonstrates robotic prostate procedure for peers

The University of Rochester Medical Centre is a leader in robotic surgery. The robotic radical prostatectomy is a growing choice for men with prostate cancer who want a fast recovery.

Joseph will demonstrate via the Internet one of the most advanced surgical procedures to treat prostate cancer, a robotic radical prostatectomy. He is head of the section of laparoscopic and robotic urologic surgery at the Medical Centre and James P. Wilmot Cancer Centre. Joseph is one of 11 robotic surgeons selected to perform a live demonstration during the symposium, where more than 500 physicians from around the world will gather to study and advance the field of robotic surgery.

Eric McEnroe, 58, is unfazed by having hundreds of specialists watching his life-saving cancer surgery. He was diagnosed with prostate cancer in December, after a routine screening by his Wellsville physician, Joseph Felson, M.D.

After discussions with urologist Gurumurthaiah V. Nagabhushana, M.D., McEnroe chose the minimally invasive surgery that Joseph has perfected. The long-time state transportation department worker was impressed with Joseph's track record of nearly 1,500 procedures and endeared by the staff.

The prostate is a walnut-sized gland in the male reproductive system located just below the bladder and in front of the rectum. The prostate contains cells that make seminal fluid, which nourishes and protects sperm. Each year, more than 230,000 men are diagnosed with prostate cancer and 30,000 men die from the disease. Although prostate cancer is the second leading cause of cancer-related death among American men, it is nearly always curable if it's caught early.

Leaders in robotic surgery

Joseph has been using the daVinci Robotic Surgical System since 2003 and performs as many as 10 robotic surgeries per week at Strong Memorial Hospital.

Removal of the prostate using the robotic technology can be done in less than four hours and most men are able to return home in less than a day. The procedure results in minimal blood loss and faster recoveries than traditional open surgery.

There are a variety of treatments for prostate cancer, ranging from “watchful waiting” to surgical removal of the entire prostate gland. Treatment options include radiation therapy, chemotherapy, hormone treatment, surgery or active monitoring - which is often chosen by older men or those who suffer from other life-threatening conditions. In these cases, the cancer may be growing so slowly that it's not likely to be fatal.

Joseph said using the robot has been a great addition to the field of prostate surgery. The system consists of a robotic arm that replicate the surgeon's motions inside the patient with great dexterity. The surgeon controls the movements from a console that allows him to see enhanced detail in the surgical field with virtual 3-D images provided by a laparoscopic camera.

When using the robot, Joseph said it's like “being inside the patient. The 3-D view provides greater depth perception and brings us closer to the surgical site, which helps improve accuracy and precision.”

The robotic system also enhances the accuracy of delicate manoeuvres such as repetitive stitching and suturing.