I, for one, welcome our new robot overlords ... uh, surgeons

August 21, 2012 | by Shawn Le

For such a small gland, the prostate stirs up a lot of debate. It seems that every month brings a new study that raises questions about how best to detect, diagnose and treat prostate cancer. And it’s that time again.

Photo of minimally invasive robotic surgery Clayton Lau, right, during a minimally invasive robotic surgery. (Photo by Alicia Di Rado)

This time it’s about the best way to operate.

When a prostate cancer patient chooses to have his cancer removed through an operation, he has a few options: a traditional open surgery, where the surgeon makes an incision across the patient’s entire lower abdomen; and laparoscopic surgery, in which surgeons operate using long, thin instruments inserted through small punctures or slits in the skin.

Robotic-assisted surgery takes laparoscopic surgery a step further. The surgical instruments are mounted on a robot, which surgeons control from a console.

Surgeons have performed robotic surgery for prostate cancer for a decade, but published studies still debate whether robotic surgery is any better than open surgery. City of Hope’s Timothy Wilson, M.D., Pauline and Martin Collins Family Chair in Urology, helped organize an international panel of surgeons to review data to see if they could come up with some answers.

So what did all these surgeons find?

Robotic prostatectomies are equivalent to open surgery in cancer control, and better for recovery from side effects such as impotence and incontinence, they report in the September issue of the journal European Urology.

According to the physicians, “available data suggest that [robotic prostatectomy] offers advantages in reduced blood loss, lower transfusion rates, and shorter length of hospital stay” than traditional open surgery.

Now, surgeons being the precise folks they are, they do point out that the experience of the surgeon is a major factor no matter which approach, and that there haven’t been randomized, head-to-head clinical trials conducted to say which approach is definitively better.

The best treatment decision for each man may still come down to a discussion between the patient and his doctor.

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