Aborted Robotic Surgery

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Fensty
New Member


Date Joined Oct 2008
Total Posts : 12
   Posted 11/14/2008 8:48 AM (GMT -6)   
After 2 months of anxious waiting, my prostatectomy surgery at Penn Presbyterian in Philadelphia via the Da Vinci robot with Dr. Lee was scheduled for yesterday. I entered the operating room about 12 noon and was told the procedure would take about 3 hours. I was awoken at 2:36 with the news that the surgery had to be aborted. Apparently, adhesions from an old appendectomy prevented Dr. Lee from getting good access to the prostate. He said there was high risk of damage to the colon. I now face a radical prostatecty. Has anyone out there had this experience?   What did you do?
 
Charlie Fenstermaker
Fogelsville, PA

RBinCountry
Regular Member


Date Joined Apr 2008
Total Posts : 270
   Posted 11/14/2008 9:11 AM (GMT -6)   
I have been on the forum and reading lots of things and your situation is a new one. I think Dr. Lee is a premier doc and surely must know what he is dealing with, but you are doing the right thing by asking around. I know what you mean when you say you now face radical prostatemy - but that is also what Divinci is - it is just a less invasive method. I assume you mean you will now undergo "open surgery." Everyone has their different challenges. Some here have chosen open surgery over DiVinci as their first choice - what I am saying is that all is not lost. Keep your chin up.

RB
Age 61 (now 62)
Original data - pre-operation
PSA: 5.1
T1C clinical diagnosis, Needle biopsy - 10 cores, Gleason 7 = 3+4 in 1 core (40%), 7 cores Gleason 6 = 3+3 ranging from 5% to 12%
All scans negative
Lupron administered 4/9/2008 for 4 months (with idea I would undergo external beam radiation followed by seed implants - then I changed my mind).
Robotic DiVinci surgery - Dr. Fagin (Austin) May 19th
Post operative - pathology
pT2c NX MX
Gleason 3+4
Margins - negative
Extraprostatic extension - negative
seminal vesicle invasion - uninvolved
1st Post PSA <.04
2nd Post PSA <.1 10/30/2008

divo
Veteran Member


Date Joined Jul 2008
Total Posts : 637
   Posted 11/14/2008 9:22 AM (GMT -6)   
Charlie, That is a bummer....but, the doctor surely did the right thing....You wouldn't want to have a bowel resection at the same time. I think you dodged a bullet there....Look at it that way... Diane
Husband Pete
dx Jan 2001 age 67 gleason 4 + 3 PSA 16.5
seed implant and conformal radiation Lupron from Jan 2001 to Jan2002
2005 Dec PSA began to rise from .5 to 8 within 6 months
Salvage surgery at MSK 9/06
Fistula operation 2/07 MSK
Many cystoscopies and ER visits with strictures
catheter for one year....Catheter taken out Sept 07..
Total Incontinence since then....
PSA .52 3/07
AUS Operation at MSK Sept 8. Dr. Sandhu
Activated Oct 28th Dr. Sandhu..MSK
Some difficulty with AUS arising Nov 10 2008


Swimom
Veteran Member


Date Joined Apr 2006
Total Posts : 1732
   Posted 11/14/2008 10:30 AM (GMT -6)   
Scarring is just one of the reasons a robotic assissted procedure may be aborted. Wonder why he didn't convert to open at that time? Sounds like a careful surgeon. Good luck with the next surgery.

Swim
 


Doting Daughter
Veteran Member


Date Joined Aug 2007
Total Posts : 1064
   Posted 11/14/2008 10:35 AM (GMT -6)   
I agree with the others that the surgeon sounds like he did right thing. I have heard of other surgeries being aborted for anesthesia complications or surgeons not performing da vinci because of scarring, but not one similar to yours. I'm sorry you will have to go through the anxiety of waiting all over again, but I hope the outcome will be the same and that you will be cancer free with minimal side effects. All the best and keep us posted.
Father's Age 62 (now 63)
Original Gleason 3+4=7, Post-Op Gleason- 4+3=7,
DaVinci Surgery Aug 31, 2007
Focally Positive Right Margin, One positive node. T3a N1 M0.
Bone Scan/CT Negative (Sept. 10, 2007)
Oct. 17 PSA 0.07
Nov. 13 PSA 0.05
Casodex adm. Nov 07, Lupron beg. Dec 03, 2007 2 yrs
Radiation March 03-April 22, 2008- 8 weeks 5x a week
July 2, 08 PSA <.02
Oct. 10, 08 PSA <.02
Praying for a cured dad.

Co-Moderator Prostate Cancer Forum


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4463
   Posted 11/14/2008 1:14 PM (GMT -6)   
I had the open RRP, with no major side effects. The incision is about 5 inch long, from the pubic bone up, heals quickly and the scar fades to almost invisible in a year or so. Physical restrictions is like any other abdominal surgery as to weight and such. One of the reported benefits of the open is it allows the surgeon to see and feel the organ and surrounding tissue, giving him/her and more hands on feel for it, resulting in maybe better and closer cutting at the margins and around the nerve bundles. I always looked at it as 6 of one, half a dozen of the other as to comparison to DaVinci.
James C.
Co-Moderator- Prostate Cancer Forum
Age 61
4/19/07 PSA 7.6, referred to Urologist, recheck 6.7
7/11/07 Biopsy- 16 core samples, size of gland around 76 cc. Staging pT2c
7/17/07 Path report: 3 of 16 PCa, 5% involved, left lobe , GS 3/3:6.
9/24/07 (open) Retropubic Radical Prostatectomy performed
9/26/07 Post-op Path Report: GS 3+3=6 Staging pT2c, 110gms, margins clear
Present- 1 year: ED- Viagra, pump continues, no response- Trimix .10ml x 2 weekly continues
Post Surgery PSA's: 3 mts-.04, 6 mts.-.04, 9 mts.-.04, 1 Year-.02.


Ziggy9
Veteran Member


Date Joined Jul 2008
Total Posts : 981
   Posted 11/14/2008 2:45 PM (GMT -6)   
Your doctor did the right thing. There seems to be a false view held here by some that robotic is better than RRP. True it appears to be less invasive but both are major surgeries. There's also something to be said that many urological surgeons prefer to actually feel the areas with their experienced fingers. That said I can sympathize which must be awful to finally decide on a treatment go to the hospital and waking up still needing treatment. Better luck next time. Take comfort you have a wise doctor.
Diagnosed 10/08/07
Age: 58
3 of 12 @5%
Psa: 2.3
3+3=6
Size: 34g
T-2-A
 
2/22/08
3D Mapping Saturation Biopsy
1 of 45 @2%
Psa:2.1
3+3=6
28g after taking Avodart
Catheter for 1 day
Good Candidate for TFT
(Targeted Focal Therapy)
Cryosurgery(Ice Balls)
Clinical Research Study
 
4/22/08
TFT performed at University of Colorado
Medical Center at Denver Fitzsimons Campus
Catheter for 4 days
Slight soreness for 2 weeks but afterward
life returns as normal
 
7/30/08
Psa: .32
 
11/10/08
Psa.62
 
April, 2009
Final Biopsy scheduled to
complete clinical research study 
 
 
 


Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4849
   Posted 11/14/2008 2:48 PM (GMT -6)   

Anyone happen to watch Doctor ā€œGā€ Medical Examiner on Discovery Health Channel.

 

She recently did an autopsy on a man that died due to scar tissue from a previous gastric bypass. The scar tissue wrapped around the colon and choked part of it off.

 

So yepper, I agree with the others that your surgeon did the right thing.


Age 53   - 5'11"   205lbs
Overall Heath Condition - Good
PSA - July 2007 & Jan 2008 -> 1.3
Gleason - 6
(biopsy done March 4, 2008-> 2 of 12)
 
06/25/08 - Da Vinci robotic laparoscopy
10/03/08 - 1st Quarter PSA -> less then .01
 

Surgeon - Keith A. Waguespack, M.D.

Las Colinas and Plano Offices

 


Tim G
Veteran Member


Date Joined Jul 2006
Total Posts : 2361
   Posted 11/14/2008 5:28 PM (GMT -6)   
Sorry to hear that you had your robotic surgery aborted, but I'm sure the surgeon did the right thing under the circumstance.
 
Robotic-assisted surgery is the newest technology available for those choosing a prostatectomy. It has its advantages, but so does open, as another posted has noted.
 
I had an open retropubic surgery and everything went smoothly and uneventfully.  I healed quickly and can barely see a scar line.
 
All the best with your treatment....Tim 
PSA quadrupled in 1 yr (0.6 to 2.5)  
DRE neg  1 of 12 biopsies pos (< 5%) 
Open surgery June 06 at age 57
Organ confined to one small area Gleason 5   
PSA's undetectable  < 0.1  


califguy
Regular Member


Date Joined Sep 2008
Total Posts : 72
   Posted 11/14/2008 10:16 PM (GMT -6)   
I had  hernia surgery 5 years ago and have continual problems since. My doc checked the CT scans and ultrasounds. He made me sign consents for both robotic and open surgery. One of the first things I remember is feeling to see if I had a long incision. They were able to maneuver the daVinci but surgery took over 5 hours because of the scar tissue.
 
(Thankfully during those five hours to get thru the scar tissue, they resolved my hernia pain and most of the swelling. So there are pluses to!)
 
So yes, it can happen.

Don't get discouraged!!
CalifGuy
 
Diagnosed Feb 2008  54 years old
3+4=7 gleason
7.5 PSA
4 out of 20 biopsies were cancerous
daVinci Robotic surgery July 24, 2008
Univ of Calif San Francisco Med Center  Dr Peter Carroll
In hospital 2 nights altho I had option of leaving the next day but stayed due to distance home.
Contained in prostate, not spread
Six weeks post surgery PSA less than .01


mvesr
Veteran Member


Date Joined Apr 2007
Total Posts : 823
   Posted 11/14/2008 10:23 PM (GMT -6)   
Don't worry about the open surgery. I had a small scar, no pain meds after the recovery room, no blood loss, two day stay in the hospital and a normal recovery. PSA's are still less than zero. I almost died from gall bladder surgery and spent four days in intensive care so several years ago so, don't worry, it will be okay.

Mika
age at dx 54 now 56
psa at dx 4.3
got the bad news 1/29/07
open surgery Duke Medical Center 5-29-07
never more than 2 pads
Tossed the pads this spring
ED still a problem
first year PSA less than zero
 


41diagnosed
Regular Member


Date Joined Jun 2007
Total Posts : 176
   Posted 11/15/2008 1:29 AM (GMT -6)   
Somewhere in an earlier post I had indicated that one of my reasons for choosing open surgery was because I have had a history of bowel obstructions due to adhesions from some congenital issue.  My surgeon said one of the benefits of open surgery is that they go in below the abdominal surgery and that I would have no risk of further adhesions.  So open surgery should be the solution for you.  I'd recommend finding an "open" surgery guy who has done lots of them.  There are the masters...mine, Catalona at Northwestern U. who has done over 5000, Partin at Johns Hopkins and Welsh...not sure which hospital, but then there are many others who have done lots.  Regardless of robotic or open, the key is experience. 
 
Good luck 2nd time around.  Hope it goes smoothly for you.
 
43 yo. now
 
5/07 PSA 4.65 at routine physical
6/07 biopsy Gleason 7 (3+4)...diagnosed at 41 y.o.
6/07-9/07 manic research and interviews with physicians across the country in search of the "right" decision.  I went to Mass General in Boston, Loma Linda, University of Chicago and Northwestern.
9/17/07 - RRP at Northwestern Memorial by Dr. William Catalona.  Thankful the father of the PSA test was right here in Chicago.
Post op path report confirmed Gleason 7 (3+4). negative margins, no seminal vesicale involvement, no lymphatic or vascular invasion, bladder and urethral free and tumor volume was 5% of 27.3g.  
9/27/07 - catheter removal...let the games begin...
12/31/07 - threw out the pads (I only had used 1 pad per day for protection against minor drips)
 
I started Trimix 8 weeks after surgery with success.  I hope someday I won't need injections, but I hope more that my PSA stays at 0 forever.
 
9/17/08 One year past surgery and doing well.  PSA less than .1 and ED continues to get better and showing reasonably good results using Levitra which for a long time did nothing. 


Fensty
New Member


Date Joined Oct 2008
Total Posts : 12
   Posted 12/3/2008 10:30 PM (GMT -6)   
Thanks to all for your comments. I too believe that my surgeon made the right decision. On Nov 14 I had an appointment with Dr. Alan Wein, Chief of Urology at Univ of Penn Hospital. He has performed several thousand open prostatectomies. Before we decided on surgery, he ordered a series of MRI studies to determine the extent of the adhesions. I had an appointment with him today and he reviewed the MRI report with me. The report indicated that I had a fair amount fatty tissue in the lower abdomen that surrounded the bladder and the prostate. It was diagnosed as lipomatosis. My first reaction was "NOW WHAT?"  I might have a little bit of a middle-aged belly, but I don't consider myself to be fat. Dr. Wein said he was confident he could still do the surgery but that there was a probability of greater blood loss because fat usually bleeds heavily when it is cut. On the positive side, he said that the presence of fatty tissue would not change the probability of impotence following surgery. However, if he felt that he could not safely remove the prostate due to obstruction of the fatty tissue, he would abort the surgery. He advised me to meet with a radiation oncologist before I definitely decided on surgery. I have an appointment tomorrow.  Stay tuned.
 
Charlie Fenstermaker

biker90
Veteran Member


Date Joined Nov 2006
Total Posts : 1464
   Posted 12/3/2008 10:59 PM (GMT -6)   
Hey Charlie,

I too have lots of adhesions from appendectomy and multiple hernia surgeries. My uro said he could do and open prostatectomy with no problem so I went with that. Had no problems and very little pain. Was dry the day after the catheter came out and use meds and shots for ED.

Good luck,
Jim
Age 74. Diagnosed 11/03/06. PSA 7.05. Stage T2C Gleason 3+3.
RRP 12/7/06. Nerves and nodes okay.
Catheter out on 12/13/06.  Dry on 12/14/06.
Pathological stage: T2C N0 MX. Gleason 3+4.
50 mg Viagra + 1000 mg L-Arginine + .03 cc Trimix = Excellent Results
PSAs from  1/3/07 - 7/17/08 0.00. 
Next PSA test on 1/28/09
Lung cancer dxed on 5/16/08.  Surgery on 6/25/08  T1N1M0 - Stage IIA  Finished 4 cycles of chemo on 11/7/08.
First CT scan on 12/2/08 - in remission!!!
"Patience is essential, attitude is everything."

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