DaVinci/ Robotic surgery

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polfred
Regular Member


Date Joined Dec 2009
Total Posts : 62
   Posted 12/26/2009 11:40 PM (GMT -6)   
Can someone explain what the DaVinci/Robotic surgery is? Why is radiation necessary after these procedures are done?
Thanks 

Magaboo
Veteran Member


Date Joined Oct 2006
Total Posts : 1210
   Posted 12/27/2009 4:21 AM (GMT -6)   
Hi miltday,
 
There is a lot of info on the net regarding Davinci prostate surgery. Just Google 'Davinci' i.e.:  http://www.davincisurgery.com/.
Radiation after any prostatectomy is usually done when a recurrence of the cancer is suspected or confirmed. Some times it is used in advanced  cases when no recurrence has jet been detected, but the cancer has escaped the prostate and spread to surrounding areas. Radiation after prostate surgery is like a second chance at a cure. Many men have no recurrences of their cancer after surgery and therefore never need radiation.
Hope this helps.
 
Magaboo
 

Born Sept 1936
PSA 7.9
-ve DRE
Gleason's Score 3+4=7, 2 of 8 positive
open RP 28 Nov 06 (nerve sparing), Post op staging T3a
Gleasons still 3+4=7
Seminal vesicles and lymph nodes clear
Catheter out 15 Dec 06, Dry since 11 Feb 07
All PSA tests in 2007 (4) <.04
PSA tests in 2008: Mar.=.04; Jun.=.05; Sept.=.08; 3 days before Rad Start=0.1
Salvage RT completed (33 sessions - 66 Grays) on the 19th Dec., 08.
PSA in Jan., 09, = 0.05; July 09, <0.04


geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 12/27/2009 7:43 PM (GMT -6)   
It would help if you could collect your information and post it as a sig (see the tabs above)

Essentially robotic surgery is the same as open surgery except through smaller incisions. Following this with radiation depends on the severity of your case. For many men, the pattern is surgery and then watching the PSA to see if further treatment is needed. My impression is that going directly to radiation regardless of the surgical outcome is an older model of treatment -- perhaps you need a second opinion
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


polfred
Regular Member


Date Joined Dec 2009
Total Posts : 62
   Posted 12/27/2009 8:06 PM (GMT -6)   

mikey1955
Veteran Member


Date Joined Dec 2008
Total Posts : 673
   Posted 12/27/2009 8:08 PM (GMT -6)   

Maybe you could post your background information, too.

DaVinci or robotic is similar to an open prostatectomy except the surgeon is manipulating robotic tools to do the procedure instead of his hands. The robotics are inserted through a few smaller incisions while the open is usually one larger one. Most claim the (surgical) recovery period is shorter than open.

There have been some good threads here about results of open vs robotic. Most have to deal with bladder control after catheter removal.

I had open. I can't tell you about robotic except that I was good to go (home) soon after my surgery. Less pain than a hernia op years before.


-Nov/Dec 07, March 08 and Dec 08: Severe perineum pain . Septra/Bactrim for 8 months for diagnosed prostatitis.
-PSA start of 2008: 5.3..... PSA June of 2008: 7.3
-14 DRE all benign or nothing felt
-TRUS Biopsy Nov 08: 5 of 8 cores positive GS 3+3 or 6. 30-65%. Perineural invasion.
-General Health: pretty good, 5' 10", 180 lbs, slim.
-Open RP surgery: May 09 both nerve bundles spared. Bilateral lymph node dissection performed. Discharged 48 hours after surgery.
-Post Surgery Pathology: pT3a N0 MX, extraprostatic extension (EPE), stage III prostate cancer, lymph nodes clear, seminal vesicles clear, Gleason upraded to 3+4 GS 7. EPE within surgical margins. Other than prostate and EPE, all tissue removed negative for cancer involvement.
-Bladder control within 48 hours of catheter removal
-ED ongoing but improving significantly with Trimix at 7 months post-op. Oral ED meds didn't do much.


Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2458
   Posted 12/27/2009 9:35 PM (GMT -6)   
I had the Da Vinci (robotic) surgery and I can attest that it wasn't bad at all. I was in the hospital for one night. The surgery is done through several small incisions. I was walking 1 mile 2 days after leaving the hospital and 3 miles after 1 week.
Age: 67 at Dx on 12/30/08
PSA 9/05 1.15; 8/06 1.45; 12/07 2.41; 8/08 3.9; 11/08 3.5 free PSA 11%
2 cores out of 12 were positive Gleason (4+4) and (4+5)
Negative CT scan and bone scan done on 1/16
Robotic surgery performed 2/9/09 Dr Fagin, Austin TX
Pathology report:
Prostate weighed 57 grams size:5.2 x 5.0 x 4.9 cm
Posterior lateral lesions measuring 1.5 x 1.4 x 1.0 cm showing focal capsular penetration over a distance of 3mm.
Prostatic adenocarciroma accounts for approx. 10-20% of the hemisphere.
Gleason 4+4
both nerve bundles removed,
pT3a Nx Mx, Negative margins
seminal vesicles clean, lymph nodes: not dissected
continent after 4 months
8 weeks PSA test 4/7/09 result <0.1
5 months PSA test 7/9/09 result <0.1
8 months PSA test 10/9/09 result <0.1

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