Treatment Advances
with Daniel Dietrick, MD
What are the advantages of da Vinci over open surgery?
A less invasive procedure, the da Vinci™ Prostatectomy is setting a new standard for surgical treatment of prostate cancer. “The da Vinci™ is the next step in the natural evolution of prostate cancer surgery. Not only is it less invasive, but it allows for less blood loss, less pain and a quicker recovery,” says Dr. Daniel D. Dietrick, MD, urological surgeon at GBMC.
Powered by state-of-the-art robotic technology, the da Vinci™ surgical system translates the surgeon’s hand movements into precise movements of micro-instruments inserted within the abdomen. Dr. Dietrick says, “The da Vinci magnifies ten times what a surgeon would see in radical prostatectomy. The images are seen in three dimensions, unlike the accustomed two dimensions. It really allows for great visualization. It’s almost as if the surgeon’s head is inside the abdomen of the patient. It is an incredible procedure.”
A da Vinci™ Prostatectomy takes two to three hours. Once the patient is asleep, five or six tiny incisions are made and the belly is inflated with gas. The eyes and arms of the robot allow for a finer, more accurate approach simply not possible in traditional surgery. According to Dr. Dietrick, “Patients usually only requires Tylenol or Motrin afterwards and are out of the hospital the next day. With a radical prostatectomy, they are in the hospital for days and experience a greater amount of pain. Also da Vinci™ patients only require a catheter for seven to ten days, as opposed to two or three weeks.”
Dr. Dietrick also reports those who’ve undergone the da Vinci™ have much better control of leakage. He attributes this to the fact that, with this procedure, the muscles surrounding the prostate are exposed to minimal disruption.
Also, the da Vinci™ is able to magnify the nerves associated with potency. This allows for much less irritation and damage, which translates into minimal disruption of the patient’s sexual life.
da Vinci™ patients also have less risk of infection, less scarring and return quicker to normal activities.
According to a study from Detroit’s Henry Ford Hospital of open and robotic prostatectomies, patients with robotic surgery lost five times less blood, had four times less risk of complications, and remained in the hospital three times less than those who underwent open surgery. Most importantly, they also had 14 percent higher rate of cancer removal.
For those concerned about robotic surgery, Dr. Dietrick says “There is no need to worry. The robot can do absolutely nothing on its own. It cannot make its own decisions. If the surgeon doesn’t move, the robot cannot move.”
Dr. Dietrick says there are only a few instances where he would not recommend the da Vinci over open surgery. The first would be when a candidate has had major radiation in the lower abdomen. The second would be for patients weighing over 300 lbs.
Surgeons have to undergo intensive training to be able to use the da Vinci™. Dr. Dietrick also believes surgeons have to practice robotic surgery regularly in order to stay proficient. He says his efforts have been well worth it, “I first operated with the da Vinci a year ago today. I’m proud to report the patient has completely recovered and is back to leading a normal life. He has minimal problems with leakage and no sexual side effects. It is truly amazing the impact this procedure has had on patients with prostate cancer.”
