I have not practiced in a hospital since 1994, so I am out of the loop for sure. I can say that I never saw any sort of surgeon being "pushed" by a hospital to do anything. Those were the good old days when the doctor was the captain of the ship. For new equipment such as CT scanners, MRI scanners, surgical microscopes, microinstruments, etc., the surgeon had to plead his case with reason but then only wait for delivery. Doctors may well propose and favor a given technique, but this is to increase his case load of experience, not to satisfy a hospital. With any new techniques, I was always fortunate enough to have partners who were ready to assist and learn with me.
The open versus robotic question will be around for awhile, but not as long as one might think. Patients and their tissues always do best with as little "touching" of tissues as possible. The sense of touch with the finger is, in my opinion, overrated.
Things have changed, but not that much.
70 years old USA citizen
Prostatic carcinoma dxed June 2009 by PSA (7.0) and then Bx
PSAs yearly since 2001 ranged 1.52 to 7.0
Neg. CT and BS
4 of 8 biopsies positive (all right side) Gleason Score 3+4=7
Robotic assisted total prostatectomy and node excision July 2009 in Luzern, Switzerland by Dr. Mattei in the Kantonsspital
pT2c G3 pN0 (0/14)
Catheter out in 5 days (home in 3 days)
Potency: beginning tumescence??? at 3 weeks post-op. Still happens at 3 months PO
3month PSA less than 0.01