RRP Vs. DaVinci

Paul--I had an open surgery.  It went well and I quickly recovered physically, although I did not go back to work until 4 weeks post surgery.  I was fully continent within about a  month of the catheter removal.

Both nerves were spared but ED continues to be a problem.  We are using penile injections; not my first choice, but the one that works best for us.

Each person's recovery is individual and dependent on many factors. I was in supremely good health before my cancer diagnosis and continue to enjoy excellent health following surgery.

DaVinci robotic is probably how most prostatectomies will be performed in the future and while there is some bells-and-whistles-woohoo-latest-greatest hype about this procedure, the fact remains that it has proven itself. 

I don't regret having chosen an open surgery.  I trusted the surgeon and felt comfortable with him.  He did open prostatectomies only  but was more than happy to refer me to a surgeon who did DaVinci robotic surgery if I wanted that. 

Johns Hopkins University urologists are odd ducks of a sort.  Their sterling reputation regarding prostate cancer was built on Patrick Walsh and Alan Partin and others who set the standard for open prostatectomy, including nerve sparing surgery.  They may not have jumped on the DaVinci robotic bandwagon because their practioners have had such amazing success with open prostatectomy.

My biopsy slides were sent to Jonathan Epstein, JHU pathologist, who is the best interpreter in the world of prostate cancer cells.  

We’re all different, so I never give a recommendation when it comes to making a decision for the type of treatment or whether to have open or robotic surgery, but I’m always glad to relate my experience in order to help someone make a decision.

I chose the robotic and was glad I did. The surgery took one hour and forty-five minutes and there were no complications. As I state in my signature below, my surgeon told me the surgery was "textbook," nerves were spared and the prostate peeled away easily. Yes, there was discomfort afterwards, but I never needed any pain medication other than Tylenol. I had no bloating, gas pains, or bladder spasms, and was walking the halls a few hours after surgery. Make no mistake I was very sore for the first couple of weeks, but as each week passed I saw big improvements. Seven months later the only indication on my body of surgery are five very minute incision marks that aren’t even very noticeable. Other than some very small stress incontinence that is infrequent, I’m totally continent and have no trouble achieving erections with the assistance of Cialis. When all was said and done, Robotic was definitely the right choice for me.

Good luck with your decision and please keep us updated.

Jack

SJC said...
 I take issue with TimG's description of the Johns Hopkins urologic surgeons as "odd ducks". They represent some of the most renowned physicians in the prostate game. Alan Partin, Chairman of the Department at JH, is another one of those experts and my surgeon. No regrets after a 48 hour hospital stay, 10 days of catheter, and total continence four weeks post catheter removal. Partin completed the surgery in one hour. No blood transfusion necessary. Very little loss of blood during the procedure. .

Also, the ratio of open and robotic is a lot closer to 50 - 50 at JH.

SJC--I was not questioning the world-class expertise of the JH docs. I've read Patrick Walsh's excellent book on prostate cancer, used  Alan Partin's (who took over as chairman from Walsh) cancer nomograms, and had my biopsy slides sent to Jonathan Epstein, JH pathologist.

My  point was that if these guys were doing 90%/10% open v. robotic, as Paul stated in his post, I thought that it may be because they wrote the book, so to speak, on open prostatectomies and might be hesitant to jump to the robotic procedure as other medical centers have done.  William Catalona is another world-class prostate surgeon (I think at Northwestern now) who only does opens. JHU prostate surgeons have proven to be among the best in the world!