Center for Robotic Surgery and Nerve-Sparing Robotic Prostatectomy
The Urologic Institute of New Jersey has established the Center for Robotic surgery and Robotic Prostatectomy in order to provide minimally invasive alternatives for genitourinary reconstructive surgeries such as pyeloplasty (correcting kidney outlet obstruction), ureterolithotomy (removing impacted stones), as well as Robotic-assisted Laparoscopic prostatectomy for localized prostate cancer.

By utilizing the da Vinci Robot, our physicians are able to re-enact traditional open surgical principals with the highest degree of accuracy and precision. Our doctors have specialty training in performing these complex operations. Our physicians perform Robotic surgery at Hackensack University Medical Center and the Valley Hospital in Ridgewood, New Jersey.

What is Robotic Surgery?

How are Robotic Prostatectomy Performed?

What are the Benefits of Robotic Prostatectomy?



What is Robotic surgery?

Robotic surgery involves use of the da Vinci robot surgical unit in performing complex surgical procedures such as prostatectomy (removal of the prostate gland usually for cancer) and pyeloplasty (reconstructing urinary drainage system from the kidney). This exciting technology allows the operating surgeon to sit comfortably behind a console and control the robot that is next to the patient to perform surgery. The da Vinci robot surgical system is now available at many centers including Hackensack University Medical Center and the Valley Hospital in Ridgewood New Jersey.



This exciting technology combines fine dexterity of laparoscopic instruments with 7 degrees of freedom, as well as 3-dimensional visualization for the operating surgeon while allowing him/her to be seated comfortably at a remote console. Consequently, robotic assistance has significantly decreased the learning curve for this technically challenging procedure.

How are Robotic prostatectomy performed?

Robotic Prostatectomy, also known as Robotic surgery for prostate cancer or da Vinci® Prostatectomy is a minimally invasive surgery that is now the preferred approach for removal of the prostate in those diagnosed with organ-confined prostate cancer. The da Vinci Prostatectomy may be the most effective, least invasive prostate surgery performed today. Though any diagnosis of cancer can be traumatic, the good news is that if your doctor recommends prostate surgery, the cancer was probably caught early. And, with da Vinci Prostatectomy, the likelihood of a complete recovery from prostate cancer without long-term side effects is, for most patients, better than it has ever been.

The operation is performed using the daVinci Surgical system and 3-D endoscopic and wristed instruments inserted through 5-6 small incisions across the mid-abdomen (See Figure below)

During the dVP, a telescopic lens is inserted into one of the small incisions. This provides a magnified 3 dimensional view of the delicate nerves and muscle surrounding the prostate, thus allowing optimal preservation of these vital structures. The cancerous prostate gland is dissected free from the bladder and urethra, and the bladder and urethra are sewn together without the surgeon's hands ever entering into the patient's body. The prostate is removed intact through one of the small incisions located at the belly button by extending the incision to accommodate the size of the prostate. These small incisions are closed with absorbable suture.

What are the benefits of Robotic prostatectomy?

The da Vinci Surgical System enables surgeons to operate with unmatched precision and control using only a few small incisions. Recent studies suggest that da Vinci Prostatectomy may offer improved cancer control and a faster return to potency and continence.

The da Vinci Prostatectomy also offers these potential benefits:
    Significantly less pain and scarring
    Less blood loss
    Fewer complications
    Less scarring
    A shorter hospital stay and faster recuperation
    Faster return to normal daily activities
As with any surgery, these benefits cannot be guaranteed, as surgery is both patient- and procedure-specific. While prostatectomy performed using the da Vinci Surgical System is considered safe and effective, this procedures may not be appropriate for every individual. Always ask your doctor about all treatment options, as well as their risks and benefits. If you are a candidate for prostate surgery, talk to a surgeon who performs da Vinci Prostatectomy.

Publications:
1. Robotic-assisted laparoscopic pyeloplasty with concomitant laparo-endoscopic pyelolithotomy of calyceal calculi.
Ilbeigi P, Lovallo GG, Bhalla RS, Sawczuk IS, Munver R; J Endourol 2005, Aug: 19(Supp): A270.

2. Use of the fourth arm in the da Vinci robot-assisted extraperitoneal laparoscopic prostatectomy: novel technique.
Esposito M, Ilbeigi P, Ahmed M, Lanteri V; Urology 2005, Sep:66(3):649-52.

Video:
1. Robotic-assisted laparoscopic pyeloplasty with concomitant laparo-endoscopic pyelolithotomy of calyceal calculi.
Ilbeigi P, lovallo GG, bhalla RS, sawczuk IS, munver R
2. Awarded HONORABLE MENTION and the ANNUAL AUDIO VISUAL AWARD
Production November 2005

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