HealingWell
Search Close Search
☰

Question About Nerve-Sparing

Support Forums
>
Prostate Cancer
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 4/20/2009 10:03 PM (GMT 0)
I talked to my boyfriends's doctor finally today. I got the impression that he thinks the standard surgery has a better chance of sparing his nerves than the robotic surgery because they can feel around more. Supposedly, there is cancer on both sides, he is T2c and Gleason 4+4. They still have to do a bone and CAT scan to locate it. I'd appreciate hearing any opinions on the differences between the two types of surgeries as far as whether one is more likely to spare nerve damage. Thanks again for answering all my questions, this all a lot to learn about.

Dana

Posted 4/20/2009 10:23 PM (GMT 0)
Thanks for the question Dana and I am sure you will get some great wisdom. From my vantage point I am not sure it matters which surgery you have as much as it matters which surgeon you choose. If the cancer is in both lobes and he is a gleason 8 please understand there is a possibilty the nerves cannot be spared. Please be supportive of that fact. These are tough life altering decisions and for the man having it done we need to feel as though we made the right decision. In the end do not second guess the outcome just offer your love and support. Please keep us posted because I will be watching to see how you two are doing. Remember Dana he needs your love and support to embark on this journey.

peace and love
dale
Posted 4/21/2009 12:58 AM (GMT 0)
Thanks Dale, I promise I won't ever give him doubts about his choice. I just want him to be as informed as possible, he's not one to research things like I am. I asked the doctor today how many of the operations he's done. He told me 30, but added that his boss who'll be there with him has done about 1,000. Does it really matter how many his boss did if he's only done 30? Do both of them do the operation or is the boss just supervising? I don't like doctors much and not sure I would trust him to give me a straight answer if I asked.

Dana

Posted 4/21/2009 1:17 AM (GMT 0)
Hi Dana, Experience of the surgeon is the key no matter what procedure he gets. I heard open allows a better view of what is going on. I had the open and have healed very well as mentioned below. Hopefully your man's is contained within the prostate and those precious nerves can be saved. Stay positive and be strong. Bob  
Posted 4/21/2009 6:05 AM (GMT 0)
I side with Bob on this one.
The surgeon's experience and reputation is far more important than the technique.

Tony
Posted 4/21/2009 1:42 PM (GMT 0)
Dana,

If the boss is there with your surgeon, that's a big help. But will he(or she) actually be there? Maybe not, or maybe not for the whole process. You have to get a sense that you can trust them. Just in case, I hope your boyfriend is getting additional opinions.

Another important factor, besides the surgeon's experience, is the condition of the patient. Very large guys, or guys with previous abdominal surgery, may not be good candidates for robotic. If everything balances out, then robotic has a quicker recovery because there is less blood loss and less trauma to the body.

DJ
Posted 4/21/2009 2:09 PM (GMT 0)
Dana The outcome of this surgery can dramatically affect your SO’s quality of life.  Find a surgeon with a great reputation, who has done many many surgeries.  Don't trust that the boss will help him out.  It's a one shot deal, you want to go into it with every advantage.  Experience is a big one. Regards, Steve
Posted 4/21/2009 2:25 PM (GMT 0)
Davinci actually requires a surgeon and an assistant surgeon, along with other support staff.

There are anumber of videos on the web that will show the process, if you want to research. My cancer was too far along so I had to go with the open. Because I healed so quickly I don't think that Davinci would have made any difference. In the hospital two days, off pain killers the third day after surgery. I was walking 2 miles a day with a week of the surgery.

My urologist/surgeon had been Chief of Surgery for awhile so I had a great surgeon.

Posted 4/21/2009 9:26 PM (GMT 0)
Hi Dana,

You are getting some great opinions here. I try not to give opinions about these sorts of things, but your question is very relevant for us. While the robotic was possible for my husband here at the time (in Australia - although newer technique than in the US at the time), after wide reading and consultation this is the second reason, why we chose the Surgeon, the type of surgery (open) and the pathway we did. First, we wanted the best chance of living (Gleeson 7 seemed to favour complete removal rather than a 50-50 radiation method alone for us), secondly - the open surgery as presented 2 & 1/2 years ago, was what we chose for the success rate of sparing nerves. I have since learnt however, that nerves can be successfully and fully spared with the robotic surgery so we will never know, but at the time, this is what we too had heard. My husband seems to have made a complete recovery with the nerve sparing open. I think it also depends on weight. I have also since learnt (not at the time) that the robotic is less successful with men carrying weight (again not everyone certainly, reading here), however the open is recommended by some docs for this reason. My hubby does carry weight but lost it prior to operation but remained overweight at surgery but ended up with successful nerve sparing from the open. However this was not the reason at the time. This is just our experience. I agree that the skill of the surgeon - whatever the method - is the essential thing. There are podcasts etc on the both procedures and also material on nerve healing overall if you do an internet search. Lana
Posted 4/22/2009 12:30 AM (GMT 0)
Greetings, Dana.  Everything I read prior to surgery said you want someone who has done the procedure at least 300 times.  I'm not sure I'd be comfortable with someone who has only done 30.  My wife and son are both nurses - if the other doc is not the one doing it don't count on the supervising doc being there much if any of the time.  Second, you need a doc that you both have confidence in.  If as you stated you don't trust him, I would at least look around for one that you might could trust.  Finally, I don't think the actual type of procedure is as important as the skill of the surgeon and the confidence you have in him/her (although I don't know many women prostate surgeons I'm sure they are out there).  I know of people who have had great success with robotic. I had open and have done very well.  Best wishes and keep us posted. David

Posted 4/22/2009 2:19 AM (GMT 0)
Thank you everyone for the very helpful advice. Your time and caring in replying is very much appreciated. Best wishes to all.

Dana

Posted 4/22/2009 1:54 PM (GMT 0)
Of the two surgeons I talked to, the one who does non-robotic was a woman. Both were highly experienced, and both knew each other and were highly complimentary of each other.

DJ
✚ New Topic ✚ Reply