|Discussion in 'All Categories' started by Rober Barera - Nov 9th, 2011 9:32 pm.|
I want to ask for prostate cancer of my father which surgery is better. Robotic Surgery or open surgery. The age of my father is 72 year nd he has also underwent cardiac bypass surgery one year ago. He is diabetic also but his diabetes is under control and he is taking 20 Unit of insulin in morning and 12 unit of insulin at night.
re: Robotic Surgery for prostate cancer by Dr M.K. Gupta - Nov 9th, 2011 9:40 pm
Dr M.K. Gupta
An analysis of cancer of the prostate comes with a double thought. The newly diagnosed patient deals not just using the fear of cancer itself, but also with concerns about a couple of the possibility negative effects of surgical treatment: incontinence and impotence. Such terrifying prospects have numerous from the a large number of men identified as having prostate cancer each year exploring alternatives to help control their cancer and hopefully prevent long-term side effects.
For several years, the prostate could only be removed by looking into making an incision within the lower abdomen, a procedure known as open surgery. Eventually, techniques were designed to take away the prostate by laparoscopy-that is, by performing the operation through small puncture holes in the abdomen and taking out the prostate through a small incision round the belly button. Although laparoscopic surgery leaves less scarring, it was not clear, based on surgeons, whether it was competitive with open surgery in helping to minimize side effects.
Since 2000, though, a new form of laparoscopic prostate-cancer surgery, performed with the assistance of a robot, has rapidly gained popularity. According to Intuitive, the organization that manufactures the DaVinci robot, roughly 75 % of today's urologists are being trained in robotic surgery for prostate removal.
When people hear the term robotic surgery, you can easily make a 21st-century cross between a human doctor and C-3PO from Star Wars, wielding surgical instruments and operating on the patient with utmost precision.
That is a common misconception, says Patrick Walsh, M.D., a urologist at Johns Hopkins, where both open and robotic prostate surgeries are performed. The standard laparoscopic surgery is not often performed any more. Patients think the robot does the operation. They do not realize that it is the surgeon behind the robot who's actually performing the surgery.
It helps to imagine the particular surgical robot itself: three or four mechanical arms that contain the scalpel and surgical instruments. The movement of those robotic arms, however, is controlled solely through the surgeon, who sits in an attached computer console and manipulates the arms with two extremely precise joysticks.
The robotic technology gives laparoscopic surgeons more precise control and magnified vision. Since the surgeon is moving the instruments indirectly with the robot, any slight tremors of the surgeon is hands are eliminated. Additionally, an automobile stick-shift-type control on the robotic console allows the surgeon to reposition his or her hands to a more ergonomic position during surgery, reducing operating-room fatigue. Finally, the screen that displays the facts of the robotic surgery shows a three-dimensional image that may be magnified as much as 12 times.
Because robotic prostate surgical treatment is billed as minimally invasive, there is a tendency for patients for begin to see the surgery as less serious than it really is.
Many patients think robotic prostate surgery is somehow non-invasive and therefore dont view it like a real surgical procedure,. But you are not only placing a needle in and magically making the prostate disappear. You're still going within the body, eliminating prostate, cutting open the surrounding tissue, and sewing everything back together. It is the same operation but with an inferior incision.
When patients weigh the option between open and robotic surgery, they often have questions. Which approach is better at controlling cancer? Which approach is the best for preserving continence and sexual function?
While the published literature on robotic surgery is expanding as well, it is still a developing field with increased questions than answers. So far, the published literature has shown that, in the hands of a highly-skilled surgeon, robotic surgery gives quite great results. These results happen to be documented in many series studies, in which a single surgeon publishes his results having a particular surgical technique.
The most famous series study for robotic prostate surgery was published by Menon, that has personally performed more than 3,000 robotic prostate surgeries as well as 1,200 open prostate surgeries. Using the robot, Menon has achieved excellent results in controlling cancer, preserving continence and sexual function, and minimizing surgical blood loss. In addition, Menon says the enhanced precision and magnification from the robot allowed him to develop new approaches to prostate surgery, techniques which are now utilized by open surgeons as well.
However, such series studies dont necessarily prove that robotic surgery is better than-or even equal to-open surgery. Instead, they merely show that the robotic technology is viable and that prostate surgeons like Menon are highly talented individual surgeons who are receiving targeted results with the robot.
What is missing are studies that a head-to-head comparison of open versus robotic surgery. Known as randomized clinical trials,such research is routinely utilized in comparing medications to alternative medications or placebos.
Although this type of study of available to robotic surgery would give patients the clearest indication which technique is better, both open and robotic prostate surgeons generally agree that a randomized medical trial comparing the 2 surgical approaches won't ever happen.
The next best type of research is the mark study, by which researchers compare the outcomes of prostate cancer patients who chose open surgery with the outcomes of patients who chose robotic surgery. Recently, several such research has been published.
If you summarize all of the literature we have got to date, it basically implies that for the long-term connection between curing cancer and recovering sexual and urinary function, the robotic surgery is either comparable to or not as good as open surgery.
But that does not actually imply that robotic surgery is less effective for cancer control. Rather, the differences are more likely due to differences in surgeon experience, since the robotic technology is comparatively new.
re: Robotic Surgery for prostate cancer by Darrance - Nov 21st, 2011 6:28 pm
|That's way more celevr than I was expecting. Thanks!|
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