Open vs. robot-assisted RP

MDNative said...
A robot doesn't make a surgeon better, experience does. And Gary, Dr. Carter did mine at Johns Hopkins 3 years ago tomorrow. Other than it all sucks, I can't complain about my results thus far.

This! My urologist/surgeon was an early adopter of the Da Vinci robot some 12 or 13 years ago and when he cut on me, he had performed 2,000 RALP surgeries. The widely advertised hospital stay for RALP is one or two days, add an extra day for open. I was discharged after a 24 hour hospital stay.

As somebody mentioned there are similar outcomes for open vs. RALP with an experienced surgeon, the scales tipped to choosing RALP was a shortened hospital stay.

I just remembered - my wife and I watched a couple of videos of RALP before choosing and I was impressed with the overall system. The surgeon has an amazing view of the prostate and surrounding tissue.

halbert said...


If you have ever eaten a soft-boiled egg from an egg cup, which end do you place 'up' in the egg cup? (do people still eat soft boiled eggs?) And do you prefer a 3 minute or 5 minute egg? And do you place the egg in cold water and bring it to a boil, or do you lower it into boiling water with a spoon? And when do you start timing?

You guys are cracking me up today!! Who uses an egg cup? I am not even sure what it is? LOL!

John_TX said...


I just remembered - my wife and I watched a couple of videos of RALP before choosing and I was impressed with the overall system. The surgeon has an amazing view of the prostate and surrounding tissue.

When i was interviewing surgeons, one of the surgeons i saw, did a whole slide presentation, followed by a video of the surgery to which he added a blow by blow description. I watched with a combination of intense interest and equally intense fear. My wife on the other hand, looked at the floor, the entire 15 minute video.

The open/RARP debate reminds me of when digital recordings hit the market in the 1980s and started supplanting analog. Analog proponents complained about the loss of aural feel in the digital recording process. The cognoscenti spurned CDs. But the handwriting was on the wall. As digital recording techniques and technology improved, the gap in the listening experience closed and the price came down, too. I suspect that the mix of technological advances and market forces will conspire to push open surgery ever farther into the corner, till it’s reserved for unusual cases that aren’t amenable to laparoscopic surgery.

When I was looking for a surgeon in Florida, I went to a Cleveland Clinic urologist for advice. He told me the evidence was that robotic produced no better results than open, but he simply did not know of any top urologist in south or central Florida who was still routinely doing open prostatectomies.

It's interesting that analog never died off and is even making a bit of a comeback. I've seen stores pop up that sell old vinyl records, and even some new vinyl. Wish we hadn't given away ours. But it was really heavy and we didn't to lighten our load to move.