Robotic Surgery - incline position

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Burlcodad
Regular Member


Date Joined Nov 2009
Total Posts : 254
   Posted 12/16/2009 8:36 AM (GMT -6)   
Trying to visualize the position of your body for the surgery.  At what point do they put you out - before or after they dip your upper body lower than your pelvic area?  If anyone has a stiff back, did the position bother you?
 
 
diag 9/09
 
age at diag 54
 
stage 2b (biopsy done because of firmness felt on right side)
 
3 positive cores out of 12 (all less than 25%)
 
Gleason 6
 
Surgery scheduled 1/13 at UP with Dr David Lee
 
 


zachattack
Regular Member


Date Joined Dec 2009
Total Posts : 97
   Posted 12/16/2009 9:42 AM (GMT -6)   
Well I went into the room of doom and met the rest of my surgical team the last one I met was the sleep doctor.the next thing I remember I woke up in recovery did'nt remember anything.Welcome to you and take care.

Zach
age 55dx 12-2008,psa at biopsy 8.6
biopsy 12/12 gleason 3+4=7
da vinci surgery 6-09 nerve sparing by DR. John W. Scott (my hero)
Hospital 3 days cath 7days still leaking from cough(bad lungs)
still have ed may be the hormones.
9-09 psa 2.2 hormone inj
10-09 nuclear bone scan no results yet I will have gold markers placed 12-29-09
start rad 1-10-10
organ confined
extracapsular seminal vesicle involvement
lymph node involvement


Sephie
Veteran Member


Date Joined Jun 2008
Total Posts : 1804
   Posted 12/16/2009 9:57 AM (GMT -6)   
Burl, not to worry - you will be in la-la land way before they situate you on the table. My husband was giving a sedative before they wheeled him out of the pre-op area - he remembers going into OR waiting area and that was it til he woke up the next morning. Tell any family or friends who will be at the hospital during your surgery to be prepared: between the inverted position and the CO2 they pump into the abdomen, my husband was all swollen (face and belly) - I told him he looked like a pumpkin! He didn't say anything about back issues so I assume the table is fairly comfortable.

By morning, he was pretty much back to normal.
Husband diagnosed in 2/2008 at age 57 with stage T1c. Robotic surgery performed 3/2008. Stage upgraded to T3a (single small EPE in posterior left). Perineural tumor infiltration present. Apex margin, bladder neck and SV negative. Final Gleason 3+4. PSA: 0.0 til July 2009. August 2009- 0.1, September 0.3, October back to 0.0, December 0.0. Thank you God!


Burlcodad
Regular Member


Date Joined Nov 2009
Total Posts : 254
   Posted 12/16/2009 10:08 AM (GMT -6)   
Thanks Zach and Sephie.  Strange as it sounds that it my big concern right now.  Apprently the position puts strain on your system and being overweight makes it worse.  My surgeon says he's done guys bigger than me and I've lost 25 lbs since the spring and am trying to keep it going up to the d date (jan 13th) 
diag 9/09
 
age at diag 54
 
stage 2b (biopsy done because of firmness felt on right side)
 
3 positive cores out of 12 (all less than 25%)
 
Gleason 6
 
Surgery scheduled 1/13 at UP with Dr David Lee
 
 


LenB
Regular Member


Date Joined Jul 2009
Total Posts : 102
   Posted 12/16/2009 10:17 AM (GMT -6)   
Burlcodad,

You have one of the best Docs is PA for the DaVinci. I had it done by a friend of his in Doylestown and all went well. You will be asleep before you are inclined. You are packed in foamrubber so there is minimal discomfort. I suffer from back pain but had no adverse effect on my back from the surgery. Chances are that if the operation is on the 13th you'll be home on the 15th. After the proceedure I didn't need any pain killers except for a couple of Tylanol.

Best of luck...enjoy the Holidays and don't worry.

Len
Age: 65
DX: 7/10/09
Gleason: 7
Biopsey: 2 chips with some cancer cells out of 30.
Robotic Surgery: 9/10/09
Cath out: 9/23/09
1st post op PSA: 10/20/09: <0.0
 
 


Burlcodad
Regular Member


Date Joined Nov 2009
Total Posts : 254
   Posted 12/16/2009 10:32 AM (GMT -6)   
Thanks Len  - Best wishes to you and your family

diag 9/09
 
age at diag 54
 
stage 2b (biopsy done because of firmness felt on right side)
 
3 positive cores out of 12 (all less than 25%)
 
Gleason 6
 
Surgery scheduled 1/13 at UP with Dr David Lee
 
 


Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4823
   Posted 12/16/2009 12:15 PM (GMT -6)   
I didn't know anything about the incline position till it was all said and done. It never even crossed my mind that it would be done that way..I didn't have any issues with being swollen either.
 
I still remember the recovery room part sucked and that I pleaded with anyone that would listen that I needed to pee pee real bad...Have a catheter inserted didn't register for a while.
Age 54   - 5'11"   205lbs
Overall Heath Condition - Good
PSA - July 2007 & Jan 2008 -> 1.3
Biopsy - 03/04/08 -> Gleason 6 
06/25/08 - Da Vinci robotic laparoscopy
05/14/09  - 4th Quarter PSA -> less then .01
11/20/09 - 18 Month PSA -> less then .01
Surgeon - Keith A. Waguespack, M.D.


geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 12/16/2009 12:35 PM (GMT -6)   
I think that I was out before they tilted the table. I say I think because the anesthesia is a hypnotic than can cause the last 5-10 minutes before it kicks in never to be saved to long term memory. That is you are still awake but won't remember it when the operation is over.

I have a weak back, but had no problem after surgery.

One thing people haven't mentioned very much is that when you wake up enough (back in your hospital room) you will be wearing these strange leggings on your calves that are hooked to a machine that inflates and deflates them every minute or two. This is to prevent blood clots, but some guys have trouble sleeping with them. I just told my self that it was my cat draping herself over my legs -- then off to sleep.
Age at diagnosis 66, PSA 5.5
Biopsy 12/08 12 cores, 8 positive
Gleason 3+4=7
CAT scan, Bone scan 1/09 both negative.

Robotic surgery 03/03/09 Catheter Out 03/08/09
Pathology: Lymph nodes & Seminal vesicles negative
Margins positive, Capsular penetration extensive Gleason 4+3=7
6 weeks: 1 pad/day, 1 pad/night -- mostly dry at night.
10 weeks: no pad at night -- slight leakage day/1 pad.
3 mo. PSA 0.0 - now light pads
6 mo. PSA 0.00 -- 1 light pad/day


60Michael
Veteran Member


Date Joined Jan 2009
Total Posts : 2215
   Posted 12/16/2009 1:19 PM (GMT -6)   
I really didnt know what position I would be in for the surgery. But surgery can take awhile and since I have a degenerated disc it must have caused or contributed to a pinched nerve. It wasnt long after surgery that I realized I could not sit long, but thought that was just part of prostate surgery. Then I developed neuropathy like symptoms and still have difficulty sitting without my donut pillow. Found a good neuroloigist now and think we are on track to fix the problem but I was in a world of hurt for awhile.
Michael
Dx with PCA 12/08 2 out of 12 cores positive 4.5 psa
59 yo when diagnosed
Robotic surgery 5/09 Atlanta, Ga
Catheter out after 10 days
Gleason upgraded to 3+5, volume less than 10%
Margin slightly involved
2 pads per day, 1 depends but getting better,
8/5 1 depend at night only, now none
 started ED tx 7/17, slow go
Post op dx of neuropathy
3 months psa.01, 6 month psa.4, 6 1/2 month psa.5
Consulting with Primary Urologist for further tx.
Great family and friends
Michael


cocrgolfer
Regular Member


Date Joined Oct 2009
Total Posts : 171
   Posted 12/16/2009 1:54 PM (GMT -6)   
The robot will probably be across the room, covered in plastic, when you go into the OR. You'll be gone long before they bring it over. It takes almost the first hour to get the thing in the proper position and up and running.

Steve

goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2691
   Posted 12/16/2009 3:51 PM (GMT -6)   
No problems for me either. I'm 6'2", 245 pounds. No swelling, no back pain, but I couldn't find my prostate when I woke up. Darn Cleveland, they'll steal anything over there !

Goodlife
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared, but carved up a little.
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks .
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)
5 month PSA <.03 (undetectable)
6 Month PSA <.01
1 pad a day, no progress on ED.  Trimix injections


Burlcodad
Regular Member


Date Joined Nov 2009
Total Posts : 254
   Posted 12/16/2009 4:10 PM (GMT -6)   
Thanks everyone for your responses.  This place is great.

diag 9/09
 
age at diag 54
 
PSA 6/09 1.3
 
stage 2b (biopsy done because of firmness felt on right side)
 
3 positive cores out of 12 (all less than 25%)
 
Gleason 6
 
Surgery scheduled 1/13 at UP with Dr David Lee
 
 


stoshb
New Member


Date Joined Jul 2009
Total Posts : 4
   Posted 12/16/2009 6:58 PM (GMT -6)   
The worst part of the surgery was that a woke up with tremendous pain in one of my feet that continues long after healing from the surgery. I finally learned that I have a pinched nerve in my lower spine and that caused the pain in my foot. My pains slowly went back to pre-op levels (I had noticed the pain before surgery, just ignored it) and all is well.

Just think this is one more "feature" of the surgery that people should be aware of. It was really strange to come out of surgery on my abdomen and complain about pain in my foot and not at the site of the surgery.

Stan
Age: 63 at Dx Aug 08
Had problems on DRE several years ago and went to "watchfull waiting"
Found new and different problems on DRE at annual physical
Even with PSA < 3 had biopsy
5 cores out of 12 were positive Gleason (4+3) and (3+4)
Robotic surgery performed 9/10/08 Dr Eric Smith, Baylor Hosp Dallas
Pathology report:
Basically one half was all Gleason 4+3
One nerve bundle removed,
No sign cancer had left the prostate
continent after removing catheter
So far no detectable PSA


English Alf
Veteran Member


Date Joined Oct 2009
Total Posts : 2211
   Posted 12/17/2009 9:03 AM (GMT -6)   
Burcoload,



I was concerned about being "upside down" for four hours. I get headaches just lying in bed without a pillow, I used to get lots of headaches in fact. I also used to have loads of nosebleeds.



I stopped worrying about the position for the robot when there was a patients meeting about four weeks before my op and I saw what most of the other guys looked like. I could see that I was defintely the healthist looking one there and reasoned that if the docs thought that these guys' bodies could cope with the slope for four hours then I most certainly could.



And my Da Vinci was fine:



These times approximate regarding what happened:

I was told I could have breakfast but not eat later than 7.00am

I arrived at the hospital at about 9.00am

I was checked in and checked over and given a tablet to take at 10.30 (sedative)

Two nurses arrived to take me to theatre at 10.45. I had my lasy pee for a week then I stripped off and put on stockings (anti DVT). Then I was taken down to prep room at 10.50 and I watched them wheel out the patient who had been robotted before me.

They put a canular in my right arm and attached (heart monitoring) knobs to my chest.

The anaesthetist injected stuff into the small of my back then big dose of stuff into arm at 11.00am; we were talking all the time

I shifted myself over to the table which had been covered with warmed blankets and some padding

Wheeled into theatre. at about 11.03

More padding starting to be strapped to my legs etc to hold me in place.

I said "hello" to surgeon at about 11.05am and said I was glad that the enormous light above me was not on. Did not see the robot even

Don't remember anything else until about half past four in the afternoon.

No back ache, no swelling, no head ache.

And no memories apart from a slight one about being in the elevator on the way to my room and the trolley bumped into something. Also I only remember the surgeon coming to see me once after the op whereas my wife says he came twice and I spoke to him on both occasions.

I also pulled the oxygen tube out of my nose and stuck it in my ear as I thought it was the earpiece of my MP3 playing.



My short term memory thus a bit of a blur, but I had expected that. I had asked my wife to take a photograph before the op and another of me as soon as she could after surgery for me to be able to see it later in case I was unable to remember it. I don't look too good in that second photo and so I found it good to know what I had looked like to help me undestand how it must have been for her. She also took a photo 24 hours after the op and I look exactly the same as I had one hour beforehand!



I felt a bit dizzy the first time I tried to get up (I had been on oxygen and a drip for a couple fo hours as my BP had dropped, but that was the only minor problem I had.) but I was able to sit on the side of my bed about three hours after the op to eat a meal.

I went home 27 hours after coming round. (The other patient stayed in hospital for a second night, yet I thought he was in better shape than me!)

Had a bowel movement the next morning.



What I did notice was that for about ten weeks after the op I didn't have any headaches and I have also got a much better sense of smell than before.



Alfred

Burlcodad
Regular Member


Date Joined Nov 2009
Total Posts : 254
   Posted 12/17/2009 11:41 AM (GMT -6)   
Thanks for the very informative response Alfred
 
All the responses are definently helping a lot.  I truly appreciate all the kindness
diag 9/09
 
age at diag 54
 
PSA 6/09 1.3
 
stage 2b (biopsy done because of firmness felt on right side)
 
3 positive cores out of 12 (all less than 25%)
 
Gleason 6
 
Surgery scheduled 1/13 at UP with Dr David Lee
 
 


Rolerbe
Regular Member


Date Joined Dec 2008
Total Posts : 235
   Posted 12/17/2009 11:55 AM (GMT -6)   

I think they've got the routine pretty well wired to avoid Pt anxiety.

"OK, sit here, now lie back and relax.  Yes, that's the machine over there under the plastic".

"We're going to give you something just to take the edge off.  By the way what do you... <insert some casual, mundane, conversational question that I either can't remember or never actually heard>"?

Wake up in recovery.

Not like sleeping, where you have some awareness that time has passed, only others can convince you it wasn't instantaneous.


51 YO
PSA at Dx: 8.2
DaVinci RALP: 10/31/08 -- Great MD in New Haven, CT
Negative margins, no extra-capsular involvement
One nerve spared
PSA at 0 for just over a year now.
 
 


Arnie
Regular Member


Date Joined Aug 2009
Total Posts : 372
   Posted 12/17/2009 4:36 PM (GMT -6)   
Hey Burl...........You'll love the care you get from A-Z with HUP and Dr. Lee, trust me. I remember being wheeled into the OR and seeeng the Robot, but didn't remember getting on the table. They start to put you in la-la land when you're being prepped. Woke up being wheeled to my room conversing with my wife who was astounded at how soon i was coming back, and how coherent i was. I was Lee's first patient of the day that day. Surgery took a little over two hours.
You can see my basic stats and progress from my signature............let me know if you have any other specific questions re: Lee/HUP/Robot, etc.
 
Arnie in DE
Age 56 (biopsy & surgery)
PSA at Diagnosis-3.9
Biposy 8/19/08--4 of 12 cores positive; 5% involvement, Gleason 6 (3+3)
 
Surgery 1/26/09-DaVinci Robotic Prostatectomy at Presbyterian Medical Center/HUP-Phila, PA
Dr. David Lee
 
Pathology Report- Adenocarcinoma, no capsular involvement, seminal vesicles clear, lymph nodes clear, negative margins, Gleason 7 (3+4), Stage T2C, NO MX, Prostate 61.8 grams, gland involvement 2-10%
 
Catheter removed after 8 days, totally dry at 3 months. ED issues continue, Viagra (via ADC) nightly (100mgs), VED use in earnest at 6 months. "Ball Park Frank" plumping at this point......ED at 10 months continues to improve, albeit slowly. Continued daily use of 100mg Viagra (ADC). Discontinued pump use; manual stimulation to varying states of erections; achieved penetratable erection on a couple of occasions
3 month PSA--<0.1
6 month PSA--<0.1
10 month PSA--<0.1


Burlcodad
Regular Member


Date Joined Nov 2009
Total Posts : 254
   Posted 12/18/2009 10:41 AM (GMT -6)   

Thanks again everyone -

 

Arnie - did you attend a preop class - I was hoping to attend one but the one in January looks like it will be after my surgery. 

 



diag 9/09
 
age at diag 54
 
PSA 6/09 1.3
 
stage 2b (biopsy done because of firmness felt on right side)
 
3 positive cores out of 12 (all less than 25%)
 
Gleason 6
 
Surgery scheduled 1/13 at UP with Dr David Lee
 
 

Post Edited (Burlcodad) : 12/18/2009 2:06:42 PM (GMT-7)

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