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Cancer: Prostate Message Board
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Old 09-26-2010, 08:02 AM   #1
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Open vs Laprascopic vs Da Vinci Robotic Laprascopic

As I've posted in a previous thread, both Irv's urologist and oncologist highly recommended surgery due to his age. They both felt that with his high-risk cancer, this would give him the best chance of success over the long term.

I think they are going to perform open surgery on him. He's since become very interested in the Da Vinci method. However, apparently there's a long waiting period before you can even be seen by a doctor who performs this surgery since only a couple of places do it. Then, if you're accepted, there's another long waiting list before you can have the surgery done. Also, I've heard that, for high risk cancer like Irv's where there's a great chance that the cancer may have spread beyond the capsule, he isn't the best candidate for this surgery.

In most cases with prostate cancer, men have the time to wait to make a decision. In Irv's case, we don't think that waiting is a good idea at all. We have to treat this cancer as soon as possible.

I'm looking for opinions on the comparison of the three different methods of surgery. According to studies, is one more effective than another? I know that the recovery time is supposed to be shorter for the laprascopic and robotic laprascopic but would the end result be the same?

Oh, the other thing I've heard is that with the robotic, bleeding is to a minimum so a lot of cauterization is done. Whereas, with open, there is far more bleeding but this may be more conducive to saving the nerves as the cauterization could actually destroy the nerve tissue. I read that blood is actually "spent" to save the nerves. We are hoping that Irv's nerves can be saved on the left side. The urologist said that this is something he is going to try to do.

I'm hoping to get some feedback on these issues. I want to gather as much information as I can.

Rhonda

Last edited by honda50; 09-26-2010 at 08:04 AM.

 
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Old 09-26-2010, 11:44 AM   #2
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Re: Open vs Laprascopic vs Da Vinci Robotic Laprascopic

Hi Rhonda,

I read your post with great interest. I think there is some misinformation about the availability and the technique related to robotic prostatecomy. Many urologists are doing completely athermal (no cautery) prostatectomy. < edited >

Kind regards,

David Peterson

Last edited by hb-mod; 09-27-2010 at 02:06 AM. Reason: Please don't post unapproved websites, per Posting Policy. Thanks!

 
Old 09-26-2010, 11:12 PM   #3
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Re: Open vs Laprascopic vs Da Vinci Robotic Laprascopic

Thank you, David. Perhaps what I was reading wasn't the most up-to-date. < edited > not enough research has been done to find a comparison between the retropubic and robotic prostatectomy with regards to high-risk prostate cancer.

Do you know of any more research done on this topic?

Last edited by hb-mod; 09-27-2010 at 02:05 AM. Reason: Please don't post unapproved websites, per Posting Policy. Thanks!

 
Old 09-27-2010, 07:21 AM   #4
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Re: Open vs Laprascopic vs Da Vinci Robotic Laprascopic

Hi Rhonda:

See this reference: http://www.ncbi.nlm.nih.gov/pubmed/20192955

 
Old 09-27-2010, 08:07 AM   #5
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Re: Open vs Laprascopic vs Da Vinci Robotic Laprascopic

Hi srhonda61,
Have you read Kcon’s original thread “PC, and I’m only 49!” ? I found this thread particularly helpful in giving me a good grounding in the surgical options prior to my own reading.
Unfortunately the unhelpful comment from many professionals that everyone is different is true. Every aspect of the process can be different and influence the outcome.
The final selection for me was basically where I started with a comment I read in Kcons thread. From memory that was choose the surgeon then allow him to choose his tools.
My experience from open surgery on Aug 19 has been very good. Pain after the operation seemed to be a non issue, I primarily used the self administered pain relief as a sleeping tablet. The wound healing has been fast and the scar tissue has had no effect in the abdominal region to this point. The only issue I have had is with the catheter and I think I am an exception to the rule here.
I am struggling with controlling my incontinence but progressing after three weeks since the catheter was removed. Sexually I can get up to 80% erect and have orgasms fairly easily.
I had no cauterization of blood vessels, small clips were used which I assume is the norm if preservation of nerves is intended.
From a basic open surgery viewpoint, even though it is older technology, I understand with advances in techniques it is still comparable in terms of outcomes with the others. Also I would think, due to how long it has been around, that it may be easier to find a highly experienced surgeon?
Open surgery does not seem to be considered as sexy as Robotics and thus does not seem to get as much coverage but my experience has been very good.
I am sorry I cannot give a more technical reference based viewpoint, hopefully others can.
Best of luck, David

 
Old 09-27-2010, 08:19 AM   #6
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Re: Open vs Laprascopic vs Da Vinci Robotic Laprascopic

Thank you so much, David, for posting your experience with open surgery. It really gives me peace of mind. There is so much to learn and so many opinions but, you're right, if you trust your doctor, then that is the most important thing. I know that Dr. Klotz is world reknowned and even if he doesn't perform the most up-to-date surgery, I've heard that he's good at what he does.

This is a tough road to travel and we all want to give ourselves the best advantage when dealing with it. It's good to be informed, to educate ourselves with regards to all of the viable options which are available. Maybe, sometimes, however, the good old fashioned "trusting your doctor" can make things a little easier to deal with.

Although I'm not undermining the importance of being an informed patient, I guess we have to learn to balance the knowledge and the trust and what is most viable, especially when time is of the essence.

Rhonda

 
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