CHOOSING A SURGEON

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anxiety out the roof
Regular Member


Date Joined Aug 2010
Total Posts : 111
   Posted 10/8/2010 11:35 AM (GMT -6)   
My local uro seems like a nice guy with over 2000 prostate surgeries in his life. I have an appointment with Dr. Partin at Johns Hopkins. I'm trying to deceide which doc to choose. Anyone have anything to say about Dr. Partin from Hopkins?

goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2691
   Posted 10/8/2010 3:30 PM (GMT -6)   
Certainly has a great name for guys wanting to part ways with their PC.

Does your local uro give any stats ?

Comfort with the doc was a big thing for me, probably more than number of surgeries.
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 injection
No pads, 1/1/10,  9 month PSA < .01
1 year psa (364 days) .01
15 month PSA <.01

proscapt
Veteran Member


Date Joined Aug 2010
Total Posts : 644
   Posted 10/8/2010 4:58 PM (GMT -6)   
One thing to check (unlikely, though) is to make sure that your local uro whom you like has his 2000 surgeries using the same method that he is planning to use with you. The doc could have 2000 surgeries using the open method, and 25 surgeries using the robot, and want to boost his robotic experience. I would not want robotic surgery from that doc.

Jazzman1
Veteran Member


Date Joined Sep 2010
Total Posts : 1160
   Posted 10/8/2010 4:59 PM (GMT -6)   
I just set up my surgery today after considering different docs and different options. There's no sure-fire way to pick a surgeon. For me, it came down to the guy having sufficient experience, being at a center of excellence, and being someone I could talk to and have some measure of confidence.

Two-thousand surgeries is quite a lot. If your guy isn't good at it by now, he never will be. My urologist said he's done over a thousand, and I'm good with that. After the first several hundred surgeries, I think the improvements a surgeon can make in his technique are marginal. As Goodlife suggested, you might want to sit down with him and discuss the probablilities regarding various outcomes for your circumstances. He should be able to give you pretty specific numbers. It would be hard for anybody here to tell you what those numbers should be; I guess you'd just have to do some comparison. However, I think if you're comfortable with him and he has your confidence, he surely has ample experience.

Partin is a star. He may do better than your guy, but you'll never know one way or the other. You only get to do this once. On the other hand, you might not get the same level of attention from a star surgeon. These guys have the whole world coming to them. There's no doubt he's a fine surgeon though.

Good luck in your decision. It's never easy, but I think you'll feel better about this once you set your course. Then don't look back and don't second guess. Lance Armstrong famously said to find the best doctor you can and then trust the hell out of him. That's really about all you can do. Good luck.
Age 55

PSA:
8/09 2.69
7/10 4.00
8/10 4.11

Biopsy 8/10
Three of 14 cores positive: 10%, 60% & 80%
Stage T1C
Gleason 6

Red Nighthawk
Regular Member


Date Joined Oct 2009
Total Posts : 289
   Posted 10/8/2010 6:26 PM (GMT -6)   
My initial uro had 17 years experience doing open, but only two years and 40 surgeries doing robotics. I left him for a more experienced surgeon with the robot. Find out how many of the 2,000 are with robotics and go from there. Good luck.

anxiety out the roof
Regular Member


Date Joined Aug 2010
Total Posts : 111
   Posted 10/8/2010 7:08 PM (GMT -6)   
They both do open surgery. I'm going for the open surgery because I'm told that it does a better job of cleaning up the margins.

fertree
Regular Member


Date Joined Jun 2010
Total Posts : 118
   Posted 10/8/2010 7:10 PM (GMT -6)   
Another thing to consider when using a "star" will be your access to him after the surgery. I passed on an experienced uro when I learned that after surgery I would be speaking to residents, others affiliated with him, and everyone but him.

Jazzman1
Veteran Member


Date Joined Sep 2010
Total Posts : 1160
   Posted 10/8/2010 8:17 PM (GMT -6)   
I think you've got to let the surgeon do his thing his way.

Trying to convince a doc who prefers open surgery to do it robotically, or vice versa, is not in your best interest.

Mavica
Regular Member


Date Joined Jun 2008
Total Posts : 407
   Posted 10/8/2010 11:22 PM (GMT -6)   
If you have confidence in your primary care physician and the urologist that doctor referred you to, then I you go with the recommendation of the doctor(s) who know you and your health history best.  A certain, minimum number of da Vinci procedures are necessary for the surgeon to become proficient, or experienced, and after than it's just running up the numbers.  I personally would not want to have someone who has the highest numbers operating on me.  I don't want to be part of an assembly line practice.  That's what some of these guys are.  Confidence in the surgeon and other medical personnel, and access to a first-rate hospital for post-op care/advice are cruicial to having piece of mind ... and a successful procedure.  I didn't go for a second opinon.  I trusted, and still trust, the persons advising me.  That's their job.  Mine was to get well afterwards.  Best of luck with whichever decision you make.

anxiety out the roof
Regular Member


Date Joined Aug 2010
Total Posts : 111
   Posted 10/9/2010 3:56 AM (GMT -6)   
fertree said...
Another thing to consider when using a "star" will be your access to him after the surgery. I passed on an experienced uro when I learned that after surgery I would be speaking to residents, others affiliated with him, and everyone but him.
good point
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