The world of surgery continues to innovate with the evolution of new technology. As opposed to the basic use of scalpels and hands which were used in times past surgeons are evolving to include highly advanced pieces of technology such as the da Vinci Surgical System which includes the use of robotic assistance. Robotic Surgery was developed to address more complex specialties such as urology and cardiac surgery.
Robotic surgery has the same advantages of laparoscopic surgery including shorter hospital stays, less pain, better visualization, smaller incisions, less blood loss and less risk of infection. The major difference with robotics is it ensures better functional outcomes and the enhanced reconstructive aspects.
Dr. David Josephson has impacted the world of prostate cancer with the application of robotic surgery. Josephson is a renowned urologic oncologist who oversees one of the most prestigious private practices in California. Due to the innovative addition of robotic surgery, Josephson is considered a leader in the field of urologic oncology. Having performed more than 1,200 robotic procedures Dr. Josephson is an advocate of robotic assisted surgery as it relates to prostate cancer.
Dr. Josephson, a pioneer and expert in robotic surgery, is unique in that he is one of very few urologic surgeons in the country who have extensive fellowship training in both open and minimally invasive techniques for the management of complex urologic disorders.
Josephson has performed many of the world’s first robotic assisted surgeries and believes it leads to the best possible outcome for his patients. Many surgeons are not aware of the benefits of this type of surgery and as a result still cling to tradition. Dr. Josephson believes this number will diminish as more surgeons gain access to the robotic surgical systems. Patients consider the expedited recovery to full urological control and sexual potency key benefits of this system.
Prostate cancer is one of the most common cancers experienced by American men; it is less common in American-Indian and Asian men. While any man can develop prostate cancer, African-American men are more likely to develop it than Caucasian men. The risk for developing this type of cancer increases with age. Although one out of every 10 men develops prostate cancer at some point in his life, it happens most often with men over the age of 50-years-old.
The occurrence of prostate cancer has nearly doubled over the last two decades. One possible explanation is men are living longer and are reaching the age when prostate cancer’s risk at its highest. There are factors that increase the risk of developing prostate cancer outside of age such as diet and family history.
While it is true that many men experience no symptoms of prostate cancer prior to being diagnosed, others may have frequent pain or even stiffness in the upper thighs, hips or lower back and either notice frequent urination, the inability to urinate or hold back urine. The existence of these symptoms may not indicate that one has prostate cancer but it is important to seek medical attention to ensure the proper diagnosis is given along with the appropriate treatment.
When speaking of the robotic surgery system, Dr. Josephson said robotics can achieve multiple degrees of movement that laparoscopic cannot. With arthroscopic or laparoscopic surgery, the surgeon has direct contact with the instruments that are touching the body, but they cannot achieve the same degree of movement as they could when using their hands. He described it as…
The robot is a system with instruments controlled by the robot on top of the patient. Surgeons also known as the masters control the robot from a central console to reach and penetrate inside the cavity of the patient. Robots are surgeons slaves replicating moves in real-time, in a scaled fashion. Any maneuver the surgeon makes with the calipers, within the console, is directly translated into the same movements within the patient’s body. We can think of robotic surgery as the new generation with updated software. Think of laparoscopy as your first generation Apple 2E and Robotic assisted surgery as the MAC Book Pro.
Robotics is an upgraded and innovative technology system which provides enhanced comfort for the surgeon and better results for the patient. Josephson said it has binocular vision and is far more comfortable than having the surgeon leaning or standing awkwardly during laparoscopy. With the da Vinci Surgical System there are two lenses looking into the body, so the surgeon essentially has stereo vision. They basically have a new sense of depth perception to create a three-dimensional visualization of the operating field.
Dr. Josephson said the robot and system will continue to evolve. It has already gone through four different upgrades within the last 15 years. He is hoping new systems are developed; this is what sparks true innovation.
The world of surgery continues to innovate with the evolution of new technology. Dr. Josephson said the future is here with the da Vinci Surgical System, which includes the use of robotic assistance. Robotic Surgery was developed to address more complex specialties such as urology and cardiac surgery. This robotic innovation leads to the most optimal outcomes for a cancer patient’s health, with more accuracy and a decreased risk of infection.
By: Cherese Jackson (Virginia)
K and B Surgical Center