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The da
Vinci ® Surgical System is powered by
state-of-the-art robotic technology. The System allows your
surgeon’s hand movements to be scaled, filtered and translated
into precise movements of micro-instruments within the operative
site. The magnified, three-dimensional view the surgeon
experiences enables him to perform precise surgery in complex
procedures through small surgical incisions.
 The da Vinci®
System enhances surgical capabilities by enabling the
performance of complex surgeries through tiny surgical openings.
The System cannot be programmed nor can it make decisions on its
own. The da Vinci® System requires that
every surgical maneuver be performed with direct input from
your surgeon.
be performed with direct input from
your surgeon.
The da Vinci®
Surgical System has been successfully used in thousands of
prostate cancer procedures world-wide.
Patient Benefits
For the clinically appropriate patient, da Vinci®
Prostatectomy offers a number of potential benefits, including:
> Less
post-operative pain
> Less risk of infection
> Less anesthesia
> Less blood loss
> Shorter hospital stay
> Faster and more complete recovery
> Quicker return to normal daily activities
Surgeon Benefits
The da Vinci®
Surgical System extends the surgeon’s capabilities to provide
these significant benefits:
> Enhanced
3-D Visualization: Provides the surgeon with a true
3-dimensional view of the operating field. This direct and
natural hand-eye instrument alignment is similar to open
surgery with "all-around" vision and the ability to
zoom-in and zoom-out.
> Improved
Dexterity: Provides the surgeon with instinctive
operative controls that make complex minimally invasive
surgery procedures feel more like open surgery than
laparoscopic surgery.
> Greater
Surgical Precision: Permits the surgeon to move
instruments with such accuracy that the current definition of
surgical precision is exceeded.
> Improved
Access: Surgeons perform complex surgical maneuvers
through 1-cm ports, eliminating the need for large traumatic
incisions.
> Increased
Range of Motion: EndoWrist® Instruments restore full
range of motion and ability to rotate instruments more than
360 degrees through tiny incisions
> Reproducibility:
Enhances the surgeon’s ability to repetitively perform
technically precise maneuvers such as endoscopic suturing and
dissection.
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SELECTING
PATIENTS
Patient selection is essentially the same as for conventional
open radical prostatectomy. Candidates for the dVP are men who
have localized disease (Stages T1 and T2); PSA levels less than
20 ng/mL and a Gleason score of less than eight, conventional
open radical prostatectomy is the same guideline used for
patient selection. In most cases, dVP is generally
performed for men who are , firstly healthy enough to endure the
risks of major surgery and secondly, have a ten year or more
life expectancy.
PRE-OPERATIVE PREPARATION
Before surgery, a testing process is conducted. History
and Physical Examination, Electrocardiogram, Chest X-Ray,
Complete Blood Count, Coagulation Profile, Comprehensive
Metabolic Panel, and Urinalysis are all part of this
pre-operative preparation.
To assist in the surgical process, a clear liquid diet is
started the day prior to surgery. In order to help evacuate the
bowel contents, the patient must perform prescribed activities
of drinking one bottle of magnesium citrate on the evening
before surgery and administer a Fleet enema at home the morning
of surgery.
Patients should receive nothing by mouth for at least six hours
prior to surgery. They are admitted to the hospital on the day
of surgery. Antibiotic prophylaxis is administered and
sequential compression stockings are applied in the
pre-operative holding area.
THE OPERATION
The dVP is performed through 5 to 6 small 1-cm incisions
across the mid abdomen. Through these small incisions, fine
laparoscopic instruments are inserted to dissect the prostate
gland, seminal vesicles, and vasa deferentia from the urethra
and bladder adhering to the same anatomic principals of open
surgery. Excellent visualization of the prostate gland and the
surrounding neurovascular structures is achieved with the use of
a high-powered telescopic lens attached to a camera device. Once
the prostate gland is dissected free from the bladder, rectum,
and urethra, it is placed in a small plastic bag and eventually
removed by extending one of the small 1-cm incisions to
accommodate the prostate. The bladder is sewn back to the
urethra to restore continuity of the urinary tract. A catheter
is placed through the penis to drain the bladder and allow
healing of the bladder-urethra connection. In addition, a small
drain is placed near the surgical site, exiting one of the small
1-cm incisions.
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POTENTIAL RISK
AND COMPLICATIONS
Proven again and again to be a safe procedure, it is important
note once again that the dVP is major surgery, performed under
general anesthesia and carries the potential risks and
complications of any major operation. Potential risks include
bleeding, infection, adjacent tissue/organ injury,
urethrovesical anastigmatic leakage, port site hernia, and
conversion to open surgery. In addition, the risks of
impotence and incontinence resulting from the dVP may
occur.
POST SURGERY
Hospital Stay: In most cases,1-2 days is the length of
the hospital stay after the dVP.
Post-Operative Pain: As the process is performed through
very small incisions, there is generally very little pain after
the dVP. Most patients recover without narcotic
medication. In many cases, patients are able to return
home on the first post operative day.
Medications: You may resume your usual medications after
surgery. Due to the risk of bleeding, it is recommended
you abstain from aspirin or other blood thinners.
Bladder Spasms: A moderate
cramping sensation in the lower abdomen or bladder are quite
common experiences, caused by bladder spasms, after
prostatectomy. These spasms are usually temporary and in most
cases decrease over time.
Urinary Catheter: Recommended for approximately 5-7 days after the
surgery. |
