Medical literature rarely deserves the credit given it. Medical research is best done by clinicians who do both lab and real patient practice. I believe that the majority of medical research reports are done for one of two reasons. One, a resident/ fellow needs to do 6 months in a lab and gets an idea given him by the grand doo dah whose name goes at the front of the author list, or two, some person aspiring to become a grand doo dah some day feels that to publish is a good way to get there. If one considers the vast number of research articles submitted to various journals and the size of these journals' editorial committees, one can see that little time is available to seriously critique a lot of these papers. Take all medical reports with a LARGE grain of salt. I have been in the lab, written a paper, and seen it first hand. My paper was the result of a lot of hard work and time, but it failed to prove anything. I guess the value in that is to show others what NOT to do.
open prostate surgery can be a grubby and bloody mess, if the wrong doctor and the wrong type of male pelvis get together. Laproscopic surgery without a robot is a different breed of cat from robotic, and I don't see how the two can be compared. I do know from years of doing micro-neurosurgery, that the better the light and magnification, the easier the surgery. A great surgeon with poor conditions is no longer great, while a mediocre surgeon can look very good in optimal conditions. The same can be said of variations in anatomy over which no one has control. open, lap, or robotic lap may all have a place. Ideally one would see one doctor skilled in each, or a clinic that had three docs doing one of each type. Then decide and have an experienced surgeon. If that factor is constant, then other factors such as peri-op morbidity and other long term complications can be evaluated in a meaningful way. Remember, rid of cancer, continence, and then sexual function. A stiff penis will be worth very little in a coffin.
Thank you for your comments. I was about
to say the same thing but with less authority. It seems all the big news agencies have picked up this story and have once again misrepresented it's content.
The study admitted that it got it's data from "medicare" codes. Unfortunately that gives very little insight into the duration or severity of a problem. It did not differentiate between robotic and non robotic surgery. So based on that, their conclusions are worthless. There is nothing in this study that even measures the skill of the surgeon, so that comment from the author is irresponsible, even if it is a possibility.
However, I would welcome a study that uses good data and can help future patients make decisions. Studies like this are just self serving to the authors and further confuse the issues.
PSA up to 4.7 July 2006 , nodule noted during DRE
Biopsy 10/16/06 ,stageT2A
Very Aggressive Gleason 4+4=8 right side
DaVinci Surgery January 2007
Post op confirms gleason 4+4=8 with no extension or invasion
no long term continence problems
Post surgery PSA continues to be "undetectable"
One side nerves spared
Bi-Mix for ED
born in 1941
Post Edited (lifeguyd) : 10/14/2009 12:55:18 PM (GMT-6)