According to a new study by The Cancer Institute of New Jersey (CINJ), new evidence proves the safety of a robotic prostatectomy with the lowest complication rates in prostate cancer treatment. This comes as no surprise to Dr. David Samadi, Chief of the Division of Robotics and Minimally Invasive Surgery in the Department of Urology at The Mount Sinai Medical Center in New York, who has performed over 3,000 successful robotic prostate surgeries in the fight against prostate cancer. "It is no secret that robotic surgery results in shorter hospital stays, less blood loss and quicker recovery of sexual and urinary functions compared to the traditional open surgical methods," said Samadi.
The CINJ study, which appearing in the August online issue of the Journal of Endourology examined the outcomes from the first 200 procedures performed at Robert Wood Johnson University Hospital, the flagship Hospital of CINJ, between January 2006 and December 2007. Twelve percent (24 patients) had a complication either during or following surgery for more than a year. Five experienced complications during surgery and 19 had post-surgical complications.
The complications ranged from grade I, or those that don't require therapy. Nine patients were classified as grade II, which required drug treatment. Six men had grade IIIb complications, which required an invasive intervention, with or without general anesthesia. There were no grade IV or V complications, which indicated life-threatening complications or death.
"What's important to note about the study was that there were no significant differences between the group with complications and the group without in regards to age, body-mass index, Gleason score and operating time," explained Dr. Samadi. The patients who experienced complications did have higher PSAs, higher blood loss and longer hospital stays. None of the 200 patients needed a blood transfusion.
"The results of the study are positive because it demonstrates a very low complication rate of twelve percent, which is very encouraging considering this study took place three to four years ago, and the technology and experience has improved substantially," said Dr. Samadi, Samadi is fellowship trained in urologic oncology and laparoscopy. He is considered an internationally recognized expert in both fields.
The study also proves how surgical experience greatly impacts success rate. The doctor who led this study performed over 650 procedures over the last five years. Dr. Samadi has performed over 500 robotic prostatectomy surgeries since his arrival at Mount Sinai in 2007. He averages 40-50 new cases per month.
Dr. Samadi's vast knowledge and experience led him to create the SMART Surgery Technique (Samadi Modified Advanced Robotic Technique), which he uses at Mount Sinai. With this technique, he duplicates the traditional open anatomical surgical technique on the robotic surgery platform for prostate cancer treatment. "The SMART technique was developed after years of practice and perfection," explained Samadi, "It should not be performed early in a robotic surgeon's learning curve."
Dr. Samadi believes that it's the surgical experience that is crucial to the success of the robotic prostatectomy. "The da Vinci robot and the SMART technique are merely tools that assist me in giving my patients a 95% cure rate, continence rates of 97% and potency rates of 81% at just 1 year," he explained, "The proven low complications rates of the robotic prostatectomy afford my patients a true quality of life."