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Posted 4/28/2009 8:28 PM (GMT 0)

I posted earlier about choosing between surgeons. The feedback agreed to go with the most experienced surgeon. Now I find out that the hospital with the supposedly more experienced surgeon would also have a resident performing at least part of the surgery because it's a teaching hospital. At both hospitals, the main surgeon has lots of experience. The hospital for robotic surgery said that the experienced doctor would be running the robot, but the resident would be assisting. Is this a lot different than having the open surgery performed by a resident with the experienced surgeon supervsinig? I'm not sure I trust that the robotic surgery hospital is being straight with me about how much of the operation the resident would be doing. Any feedback is greatly appreciated.

Dana 

SO diagnosed 4/15/09 age 47

PSA 10

Right side= Gleason 4+4=7, 40% involved, 5 out of 6 cores positive, perineural invasion present

Left side+ Gleason 4+4=8, 60% involved, 5 out of 6 cores positive, no perineural invasion present

T2c

Posted 4/28/2009 8:36 PM (GMT 0)
Dana....I don't know exactly...I know that in robotic, there is an assistant...but from what I remember only one surgeon is at the console that operates the robotic arms and I would think that is the guy that needs to be well experienced. I would imagine that an open surgery is similiar. I think that when you have major surgery, two surgeons are always there, with one being the lead the other assisting or learning.

BTW...a teaching hospital can be a good hospital...I know the one here in Dallas that I used for skin cancer was great...even though I had a full team of surgeons around me during the surgery...memory was 8 I think...but the point is, a teaching hospital should not scare you away.

Lets see what the others say on this...
Posted 4/28/2009 10:23 PM (GMT 0)
The robotics surgery team usually consists of the surgeon on the controls of the machine, usually removed a few feet from the patient, a resident at the patient who assists the surgeon by adding or removing the various attachments to the robot arm, helping insertion, removal of instruments and probably closing of the wound after. A nurse is also present with the patient to document paperwork, assist the resident, also an anaestesiologist (misspelled badly).
Posted 4/28/2009 11:59 PM (GMT 0)

Dana:

If I HAD to choose between the two and I thought they were being straight with me, I would choose the situation where the experienced guy is the principal surgeon and the assistant is the one who is less experienced.  No way would I let the inexperienced guy be the principal. 

However, when I was looking at robotic surgery as an option, the experienced practioners I was considering had a partner (NOT a resident) as the assistant.  That is, BOTH surgeons that participated in the procedure had hundreds of procedures under their belt.  I try to give advice on this forum as if I was choosing something for me...so, I would personally find a practice where ANY physician participating in my procedure had hundreds of surgeries completed.  Teaching hosptals are great...I just don't want anyone learning on me unless they are just watching...Just my take...

Tudpock

Posted 4/29/2009 12:58 AM (GMT 0)
When you sign the consent form you can write in terms that are important, for example "only Dr. Smith to perform nerve sparing procedure" and let them know that this is important to you.
Posted 4/29/2009 2:22 AM (GMT 0)
My dad had a resident that did assist on his procedure. I hope not too much of the actual procedure, but after the surgeon informed my mother and I that my dad was out of surgery and that things went well, the resident is the one that came by the room later in the evening to check on my dad and ordered meds etc. All the follow up appts and everything like that were with the surgeon. The catch with going with the large teaching hospitals, is that there are going to be residents. It is definitely a personal decision, that only you can make. Best wishes!
Posted 4/29/2009 2:25 AM (GMT 0)
With my open surgery, my urologist-surgeon was the lead surgeon, and his back up, and I was told was required by law, was his partner, who happened to be the only surgeon at the time to do robotic, which I didn't have. I would insist on going with the senior level experience surgeon to do the primary work, robotic or open. You got one shot to do this right, and you need the best you have resources and access too.
Posted 4/29/2009 2:34 AM (GMT 0)
The thing about robotics is there can only be one primary surgeon. There's only one set of controls... tongue Those controls are the only ones inside the body doing the removal...There's several videos on youtube showing a RRP from beginning to end, in case anyone wants to see the whole deal...
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