Surgeons in City of Hope’s Division of Urology and Urologic Oncology recently performed their 5,000th robotic prostatectomy, a medical milestone achieved by few other hospitals around the country.

A prostatectomy is the surgical removal of the prostate gland; it is a common way to treat prostate cancer. Traditional open surgery often requires a long, large incision. At City of Hope, surgeons perform most prostatectomies using the da Vinci Surgical System, which allows them to operate precisely through small incisions in the skin.

Kevin Chan performs a urologic procedure using a robot. (Photo by Walter Urie)

City of Hope performed its first robotic procedure in 2003, and patients have flocked to the medical center in the years since, drawn by the urology team’s expertise. The robots’ popularity has stretched nationwide, as well. Today, four of every five prostate cancer operations in the U.S. are done with a surgical robot, according to the National Cancer Institute.

Research has shown that patients who undergo robotic prostatectomies lose less blood and leave the hospital faster than those who undergo open surgery. Recovery time may also be shorter following robotic surgery than open surgery.

The most common side effects of a prostatectomy are incontinence, erectile dysfunction and pain during healing. Physicians have no clear answer yet on whether robotic prostatectomy results in fewer urinary or sexual problems than other minimally invasive techniques that use handheld tools.

But numerous studies, such as recent ones from Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical College in New York, show that prostatectomies performed by more experienced surgeons result in fewer and less severe side effects reported by patients.

Patients at City of Hope count on surgeons who have performed thousands of the procedures. “City of Hope brings together advanced technology and compassionate care to provide the best treatment possible to patients,” said Timothy Wilson, M.D., Pauline and Martin Collins Family Chair in Urology and director of the Prostate Cancer Program.

“While robotic surgery may be cutting-edge, you also need expert hands to guide those cuts — experienced hands to best balance the post-treatment concerns of the patient against the immediate treatment of the cancer.”

Since its first procedure in 2003, City of Hope has expanded the range of cancers that are treated through robotic-assisted surgery, as well as expanded the number of robots in use at the institution.

Four da Vinci robots now reside in City of Hope’s operating rooms, assisting surgeons in treating head and neck, lung, esophageal, kidney, gynecologic and colorectal cancers.

City of Hope surgeons often help pioneer emerging robotic procedures and techniques; recently, a City of Hope surgeon was the first in California to use a new technology that causes healthy tissue to glow during surgery, enabling him to more precisely remove tumor tissue and minimize organ damage. City of Hope’s surgical team is investigating the use of the fluorescent technology to improve prostatectomies, as well.

“Many of our prostate cancer patients are concerned about the side effects of treatment impacting their lives, robbing them of their vitality,” said Wilson. “We are helping develop new techniques with the da Vinci that allow for even greater precision during surgery as well as conducting clinical trials and a prostate cancer survivorship clinic that addresses quality-of-life issues after treatment.”