Robotic prostatectomy protects sexual function
Detroit, USA. Patients who underwent a robotic radical prostatectomy had
significantly better erectile function outcomes than those who received
conventional nerve-sparing surgery — without compromising cancer control,
according to a year-long study conducted by doctors at Henry Ford Hospital's
Vattikuti Urology Institute.
The results should help ease men's concern as to the future of their sex
lives when faced with a radical prostatectomy, the surgical removal of the
prostate and surrounding tissue, one of the most effective prostate cancer
"The potency outcomes with our robotic surgery are the highest reported
to date," said Mani Menon, M.D., director of the Vattikuti Urology
Institute. "Of the patients undergoing the procedure, 97% achieved erections
strong enough for intercourse —with about half not requiring medication to
do so." Sexual function was assessed by having the men fill out
questionnaires a year after the operation.
The institute has performed more than 2,100 robotic prostatectomies, more
than any other hospital in the world. The study is published in the December
issue of the Journal of Urology.
While the main objective of a radical prostatectomy is cancer control,
maintaining the patient's quality of life is an important secondary goal.
Many studies have shown that the most common factor, which decreases quality
of life is reduced erectile ability. While more conventional procedure
leaves most men with some erectile function, many find their erectile
ability has decreased.
In addition to lowering the risk of impotence, robotic surgery
significantly reduces pain, blood loss, risk of incontinence, and recovery
time, compared with the traditional radical prostatectomy.
In the robotic procedure, which was developed at the Vattikuti Urology
Institute, doctors use a robotic arm to perform the surgery. The surgical
site is magnified 35 times, enabling the surgeon and team to have better
with the instruments and increase ability to identify areas where the cancer
may have spread. The technique, that the Menon team developed, and is not
available elsewhere for the moment, preserves the prostatic fascia, which
appears to improve the quality of nerve preservation during the robotic
The procedure is performed in an operating room with three-dimensional
technology and two 60-inch by 80-inch flat projection screens, along with
advanced lighting and a data monitoring and intercom system. The surgical
team works in 3-D wearing special polarized glasses.
Using a tiny camera at the end of a laparoscope, the surgeon can operate
miniaturized instruments at the end of other laparoscopes from a remote
Henry Ford Hospital has two da Vinci Robotic Surgical Systems that are
used to perform robotic prostatectomies as well as other procedures.
Prostate cancer is the second most-common cancer in men next to skin
cancer. The American Cancer Society estimates that more than 232,000 new
cases will be diagnosed this year in the United States, and more than 30,000
men will die from the disease. Prostate cancer is the second-leading cause
of cancer death among men in the country.