da Vinci v open surgery

Colin,

I applaud you taking the time to do a thorough evaluation.  Go with your gut, whichever way that leads you.  Peace of mind and avoiding a lifetime of second guessing after the fact is always a consideration.  Of course anything can happen in any given case, so also don't look back after the fact.

I too am generally a quick decision maker.  I too was 'thrown for a loop' and dithered on this decision.  In my case I had to travel about 300 miles in the states to get the experienced surgeon I wanted for a Da Vinci procedure.  I am tremendously glad I did.

Best wishes for you.

Hi folks,

Can I just add my own comment on this one.

I guess I am in a strange positon as I (39 year old) had robotic surgery in April 2009, and my father (60) had open surgery in 2005. Both operations were done by the same consultant!

Anyway, for me robotic was really the only option as it would help to preserve my male functions and was less invasive/better recovery times etc. For my father, there was no such need to preserve his functions as my mother and father had decided that the time was right to not have to worry about that side of things anymore.

At the end of the day, as has been already said, go with your gut insinct, but make sure you are as close to 100% happy with your choice of surgery and surgeon as possible.

Good luck, and just remember that we are all here for you.

My open was at 7am , went home the next afternoon at 5pm.  Could have gone home at 8am, but doctor suggested I stay to let him remove the drain and cover aftercare, rather than the nurse.  Had a 'normal' for surgery recovery. 

I don't know what the difference would be in the time in hospital.  In my case, the doc wanted me up and moving, and out of the hospital as soon as possible.  I had the surgery starting at 7am, was back in my room at 12noon (a blood pressure issue stretched it a little) .  I had to wait for the physical therapist to 'escort' me for my first walk, which was at 2pm.  I walked 3 more times that day unassisted.  Once I was able to walk, I didn't stop.  I took frequent but short walks, as many as I could manage.  I am convinced that walking as much as possible and extending each day, along with as much water drank as possible was the key to my quick recovery.  I liken my trip to what I have read here from the Davinci guys. 

I went to see the open surgeon today he told me he as been doing 5 of these a month for the last 20 years no frilly stuff cannot say the nerves will be spared everyone different says ED 50/50 continence 95% so i have been pencilled in for the 27th July just have to have my blood check for the bleeding problem and my heart checked if all OK then all sorted He did ask me why I never went Robotic when I told him that the doctor was trying to sell it to me to much and he never even checked my prostate and was going on what other said I told him main thing that worried me that he said he had got the operations down to under 90 minutes which I said unsettled me and surprised the surgeon and I think that he understood my reasoning. Well I have made my decision at least that is over with and I must admit that I feel much more comfortable with this surgeon and a little bit more at peace with myself (well till the 26th)

It is good to hear that you have a surgeon that you are comfortable with. With respect to nerve sparing I think he said what any responsible surgeon would say. My doc told me that his first priority was to get the cancer and that, based on my biopsy, the nerves on at least one side might have to go. After the operation he reported that both sides had been spared.

Tomorrow I go for my 3 month blood draw (my doc doesn't do 6 weeks) and then we will see where things stand. No matter what, this group has helped tremendously and I will face whatever needs to be faced -- even if it means that I have to start paying dues to the zero club. I hope to see you there in about four months.

I don't know your situation with children, but with you being 64, and with a 4 month old child, you might want/need to consider banking sperm for any further children.  Just a thought that lots of us older guys don't think of. 

Several thoughts re Robotic vs traditional surgery:

First I recommend if you haven't done so already, view several of the excellent web casts on the internet of the complete robotic process. I watched two procedures, one from Mount Sinai hospital and another from a Memphis hospital - with both surgeons using slightly different techniques. Understanding and seeing the surgery performed was for me a great help.

Secondly I had the robotic surgery and I focused heavily on the surgeon (to date he had done close to 3000 procedures) as well as the hospital, went to a teaching hospital.

Finally, and I think this is important if your PSA# and Gleason score indicate you were detected early the robotic process gives you two pluses - one a surgeon sees everything magnified by a factor of x15 and the surgeons hands don't obstruct his vision. If your situation is more advanced a skilled surgeon feeling his way around maybe more critical. Let me conclude by saying that my experience with the robotic process was excellent, I experienced absolutely no pain and I was released the next day. It is still to early for me to say if I will have any other issue but I will say that three weeks after surgery I feel great! Hope my input is of some help and wishing you the best!

My surgeon has done over 2,300 open surgeries, and over 600 Robotic. He recommended to me, the Robotic, which is what I went with. (He included in the discussion that if I had some strong preference for the open, then he gladly would have done the open on me. His main reasons for the Robotic preference, as compared to open, were (1) less blood loss, (2) shorter recovery period, (3) smaller incisions, (4) greater control, to go in an save the nerve bundles. For whatever it is worth, he is considered by many to be one of the top 2 or 3 in the country. (I mentioned to him that Dr. Patrrick Walsh's book recommended against Robotic, and the book totally recommends the open surgery. He replied back to me, his awareness of the book, and that he and Dr. Walsh are quite close. He mentioned to me, something that Dr. Walsh's book did not mention, and that was the fact that Dr. Walsh never does Robotic surgeries, and that is a major factor for why he (Walsh) recommends against them. My surgeon, over many years, has found the Robotic to be far more precise (and this comes from a surgeon that thousands of people consider to be one of the best "open" surgeons in the United States.

But, as others have said, and I do agree. You do have to go with what you are comfortable with. And not just take the words of others.

geezer - Excellent point.

My wife used to say "everything is going to be fine" (this after the first PSA, and then again after the second PSA, and finally after the biopsy) I finally told her to find different words to say to me. She realized my point (because everything was not fine after each test, and each next step, things continued to get worse). Finally, she began saying "I will be there for you, and will love you, no matter what". And, after she started saying that, things did get better, and the results were good, and the surgery went fine.

Colin - we will be here for you, in every way that we can.