PAOLI, Pa. (June 2008) — Robotic-assisted minimally invasive surgery for prostate cancer is now being offered at Paoli Hospital, which has acquired the da Vinci® Surgical System.

"The da Vinci allows us to perform complex, minimally invasive surgery with much more precision than we can with standard laparoscopic instruments," said James R. Bollinger, M.D., Chief of Urology.

Robotic-assisted prostate removal is about four years old, and the technique has been gaining ground since its introduction. Dr. Bollinger has performed more than 40 prostatectomies with the da Vinci.

The advantage of the da Vinci is its ability to deliver exceptional imaging and fine surgical maneuvers in delicate areas, such as the prostate, where it’s vital not to damage nearby nerves that control bladder and sexual function.

Patients experience less pain and less need for blood transfusions. They recover faster, return to normal activities sooner, and they regain continence and sexual potency on a par with open surgery.

Recent studies suggest the da Vinci may improve cancer control and reduce the risk of urinary incontinence and impotence. "We feel the superior magnification that we have when we look at the prostate gives us a better chance of getting all the cancer out," said Dr. Bollinger.

According to Dr. Bollinger, over the last three years, the incidence of robotic prostatectomy has increased from 30 percent to 64 percent, while the incidence of traditional laparoscopy has stayed about the same at less than 5%.

"I think robotic prostatectomy clearly represents the future of prostate cancer surgery," Dr. Bollinger said.

Other than skin cancer, prostate cancer is the most common cancer in American men. The American Cancer Society estimates there will be about 186,320 new cases of prostate cancer in the United States this year. About 1 man in 6 will be diagnosed with the disease during his lifetime, although the death rate is only 1 in 35.

Three urologists—Dr. Bollinger, William Merriam, M.D., and Donald Anderson, M.D.—will inaugurate the da Vinci’s use at Paoli for prostate cancer surgery, but Dr. Bollinger expects future uses in cardiology and gynecology.

The da Vinci takes minimally invasive laparoscopy, developed in the 1980s, to the next level. In laparoscopy, the surgeon, using special instruments, operates through several small holes about the size of a pencil. The surgical field is projected onto video screens by a tiny camera inserted through one of the incisions.

The da Vinci enhances the view with 3-D imaging and provides tighter instrument control. Seated at a console viewing an image of the prostate, the surgeon guides the master controls, which translate hand, wrist, and finger movements into precise movements of the micro-instruments inside the patient. Up to four robotic arms can mimic and execute the surgeon’s actions.

With its ability to edit out tremors and scale hand movements, the da Vinci produces a new level of precision beyond the limits of the human hand—most important in prostate cancer surgery to preserve the nerves for urinary and sexual function.

"The da Vinci has made the experience for the patient and the surgeon much more gratifying because people are able to get back to their normal activities much quicker and they have much less discomfort," Dr. Bollinger said. "It's just a significant improvement."

Media Contact:
Frieda Schmidt, Public Relations
610-526-8298

Published:7-7-2008