Regular laparoscopy v.s. Da Vinci Robotic ?

WhoFan, 

We too were torn between the 2.  All the local docs here due the open.  There is one guy who just started the Da Vinci, but the others all do open.  The doc that we decided to go with locally, if we chose the open said that the only true difference was the loss of touch.  He said that if he felt a hard spot, he would cut wider. 

We then talked to a local onocologist who I knew.  He said that if it were him, he would go with the DaVinci, and Dr. F.A.G.I.N in Austin was the best in our part of the country.  He said that the only true difference was the healing time, with DaVinci winning that race. 

I watched a live prodcast of the da vinci and another that Dr. F sent us.  It was amazing.  And it talked about cutting a little wider when needed.  That, coupled with the faster healing time made up our minds.  Kurt had the Da Vinci last week, cath allready out and healing beginning.  Good luck with your decision.  Everyone has to chose their own course and believe that it is the best one for them.  This is just why we chose the way we did and NO regrets!!  Courtney

Yes Linda & Bob,

We are not even considering "open surgery"....Just regular laproscopic which is done by human hands or the robotic da vinci. Both are less invasive than open surgery; but which is really the better one?? Like we said in our first post, we were all about the "da vinci" but the radiation oncologist now urged us to consider both da vinci and the "human" laparosopy route. Again he claimed that one is not necessarily better than the other. Gosh, do these decisions ever end? It's mind-boggling!

Bob had the regular laproscopic? Sounds like he did well.... the recovery is probably just as good as the da vinci.

Thanks.....
WHOFAN (Cynthia & David)

Sorry about the mis post. What we have been told told regarding lap vs the da vinci is that the robot's precision is greater. We didn't really research much after that. My grandfathers best friend had the lap 5 years ago and is doing great. My grandfather called me in the beginning to tell me to tell kurt that his friend could still have an orgasim. Not something I ever wanted to hear my grandfather say, but...... haha. Good luck in your search for answers. Courtney

Hi Cynthia,

I have read that traditional laparoscopic surgery is more difficult to master and the hand movements are counterintuitive (ie.. turn right to go left). With Robotic the magnification of the surgical field is much greater and the range of motion for the surgeons hand movements are greater.

I pasted a link on your earlier thread to an interview with Dr Kawachi. He is also an expert with traditional laproscopic surgery and he describes the differences between the two.

Cheers,
Joe

To Cynthia and David:

I learned after extensive research that if you opt for surgery, your next #1 decision should be the surgeon, not the type of procedure.  You want to make sure that your surgeon has extensive experience (which means a good patient track record for success) and exemplar credentials (he's smart).  There are experts at lap surgery, Rob/lap surgery and open surgery.  I could not find a single surgeon who was an expert at more than one.  Therefore, when you go to a urologic surgeon, he will tout only whatever procedure falls within his expertise.

Not all surgeons are experts (in other words, not all have extensive experience and exemplar credentials).  I suggest you make your decision primarily on the fact that your chosen one meets the high standards of excellence I set when making my selection this past June.

For example, my chosen one was based at Hopkins and had performed more than two thousand "open" prostatectomies over the past 15 plus years.  He had an excellent track record and is reknowned in the academic field.  My surgery took one hour, I was hospitalized 48 hours, I did not need a transfusion because I lost little blood, I used only 28 pads total (one per day for four weeks when I went pad free), I returned to work part time 12 days post surgery (office job) and full time four weeks post surgery, recommenced my running exercise program six weeks post surgery and was up to seven miles at the seven week mark with no stamina or continent problems (9:30 mile pace).  Age 50 at time of surgery.  <0.1 PSA three months post-surgery.  I give credit for the success of surgery and speed of recovery to God and my surgeon's ability.

The point I'm making here for you is the type of procedure should not be your #1 concern.  There are urologic surgeons who are "experts" as I have described and there are those who are not at that level of skill and brilliance.  You should set as your #1 criteria the selection of nothing short of an "expert" to perform whatever procedure he specializes.  That's how you get the result I got a few months ago.

whofan

i elected radiation treatment but did extensive research and considertion on surgery before deciding on my treatment.  if i had elected surgery, it would have been robotic.  one article i read indicated that mastery of lathroscopic prostate surgery (before robotic surgery became available) is very difficult and for the doctor performing the surgery it is like performing the surgery looking in a rear view mirror.  in today's world, either have the open radical surgery or robotic.

dave

Cynthia, my best to you whatever decision you both make.

I agree with SJC, once you decide to have surgery, the surgeon is the most important decision.  In my case, my surgeon had done over 1000 "open" RRP's and admitted that he did not have experience with laparoscopic procedures, talked about the "touch" advantage that he felt open surgeries allow, but also would refer out if I insisted on a LRP.  I was able to check the State Medical Examiner website prior to making my original appointment to make sure there was no history of complaints, lawsuits or malpractice.  I also spoke with two of the doctor's patients/families that had been through the procedure.  With this I made my decision to proceed, and I am pleased with the results so far.

My prayers are with you for guidance, strength and knowing that whatever decision you two make, that you will have success.

I wouldn't recommend LRP. It's past technology. Robotic will replace it completely in the future. Cost is the only reason we still have LRP. Medical centers won't be in any hurry to replace LRP because of their investment. It is very difficult for surgeons to master LRP. I know some have had successful LRP procedures but not everyone will be blessed to have the best surgeons. My surgeon lied to me on the phone when I asked him how many he had done and he told me about 240. The night before the surgery he told me he had only done 50. Maybe I was one of those rare cases but I was under for 10 1/2 hrs. He told me that my surgery was his most difficult. Surgery was about 8 hrs. Lost 5 pints of blood. Being under anesthesia for very long has long term negative consequences on your body.
Ron