Thursday, March 18, 2004

Robotics used in prostate surgery

By Matt Leingang
The Cincinnati Enquirer

Anesthesiologist Dr. Al Lopez (left), surgeon Dr. Eric Kuhn, Dr. Brian Seifman (seated) and certified surgical assistant Ronald Campbell (across table) work at the operating table Wednesday.
The Cincinnati Enquirer/GLENN HARTONG
Tristate men with prostate cancer are the latest group of patients at Greater Cincinnati hospitals to benefit from robotically assisted surgery, which promises less pain, shorter hospital stays and faster recoveries.

On Wednesday, surgeons at Good Samaritan Hospital used the technology on a 56-year-old man to remove a cancerous prostate.

Sitting at a 3-D video console off to the side of an operating table, Dr. Eric Kuhn used joysticks to direct four robotic arms, inserted into the patient's abdomen, that mimic the surgeon's precise motions.

Since robotically assisted surgery came to Cincinnati last year - Good Samaritan has one; the University of Cincinnati Medical Center has two - it mostly has been used for heart procedures.

About the da Vinci Surgical System (2.3 MB PDF file)
This was its local debut in prostate surgery, enabling surgeons to avoid the traditional "belly cut" from a patient's belly button down to his pubic bone.

But more importantly, doctors said, this minimally invasive technique - which causes less harm to nerve bundles around the prostate - may offer men with prostate cancer an even lower risk of impaired sexual function after surgery, better urinary control and no risk of damage to the rectum. In Hamilton County, 597 men were diagnosed with prostate cancer last year, according to the American Cancer Society.

"A lot of things in medicine come and go, but in the short time that this technology has been around, it's really proved itself," said Kuhn, a urologist at Good Samaritan who, along with Dr.Mark Delworth, spent 10 months training with the robotic system before Wednesday's surgery.

Kuhn said the five-hour surgery went well and that the patient is expected to return home today, whereas conventional surgery typically means a two- to three-day hospital stay.

TriHealth, the hospital system that includes Good Samaritan and Bethesda North, did about 100 prostatectomies last year.

Prostate cancer is the most common cancer in men. The American Cancer Society estimates that 220,000 new cases were diagnosed last year in the United States and that more than 30,000 men died from the disease, making it the second-leading cause of cancer death in the country.

Annually, more then 50,000 men in the U.S. undergo a prostatectomy - the complete removal of the prostate and surrounding tissue.

Hospitals in Detroit began pioneering robotically assisted prostatectomy several years ago, said Kuhn, who has two other cases scheduled for March.

Good Samaritan could do as many as eight to 10 procedures a month with the new technology. UC expects to do its first kidney removal surgery this week and its first prostatectomy sometime this month.


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