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Fall 2005

Robotically Assisted Prostate Surgery Improves Precision

Minimally invasive and robotic prostatectomies shorten length of hospital stay and recovery time

For men found to have early-stage prostate cancer, the nerve-sparing radical prostatectomy has long been a common option, particularly when remaining life expectancy is at least 10 years. In the hands of experienced surgeons, the removal of the prostate gland and surrounding tissue has a high likelihood of success, both in eliminating the cancer and in preserving potency.

Minimally invasive (laparoscopic) prostatectomy, which capitalizes on the latest fiber optics technology to enable surgeons to poke needle-sized holes into patients, obtain pictures of the surgical site with 15-fold magnification, and insert miniaturized instruments to remove the prostate, has also been offered at UCLA for a number of years, with comparable success rates. “The advantages to patients include a shorter hospital stay and recovery time, and less pain and scarring. As a result, more patients who face surgery are requesting a minimally invasive procedure, which is driving advances in instrumentation,” says Peter Schulam, M.D., Ph.D., head of UCLA’s Division of Endourology, Stone Disease and Laparoscopic Surgery.

More recently, UCLA urologists have taken minimally invasive prostate cancer surgery a step forward with the introduction of robotic instruments designed to provide improved surgical precision. Robotically assisted laparoscopic prostatectomy involves the use of instruments that can act like a human hand, giving surgeons greater flexibility as they use the robot to manipulate tiny surgical tools inside the body.

 “The advantage to this approach is that the surgeon can sit at a console, get a three-dimensional view inside the patient, and move the instruments with the full natural range of motion,” explains Robert Reiter, M.D., co-director of the UCLA Prostate Cancer Program. Among other things, this additional precision may improve the likelihood that the patient’s potency will be preserved following the surgery.

Most patients with early-stage prostate cancer are candidates for robotically assisted surgery.

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