the downside of doing more than 1000? Does the doc become blasé? Does the mind wander? "Only 3 more of these to do today and I can go to the staff party." "Which patient is this? Is he number 2 or 3 today? Is he the one with the high PSA that's taking the chance or is he the one with the family history?"
Do anything more than 1000 times and it begins to blur. (Just like women. I can't remember #1004 from #1006.)
Can the high success be related to something that is not just the number? How about
this theory: The successful docs get more patients referred to them so their numbers go up? Or, the docs with high numbers are in their 40's and 50's and are more stable and don't go out partying the night before.
As clocknut pointed out if it really takes 1600 operations to become proficient then we have a serious problem with the method. We're not baking pancakes here. It is not OK to throw out the first ones just to get the pan ready.
Here's a real innovative idea. How about
turning on the 1 TB hard drive plugged into the back of the DaVinci and have it record the camera video and offer the 2 hour CD to the patient as part of his record? That way the patient can see exactly what happened. Was the Cowper's Gland spared? Was that nerve really spared? Did you lose half your bladder sphincter and will be incontinent? The patient can plan his recovery accordingly.
I would go to any surgeon who had the
confidence to offer that service to a patient. That surgeon would have 1000 notches under his belt in no time.
Age: 58, Mar 35 yrs, 56 dx, PSA: 4/09 17.8 6/09 23.2
Biopsy: 6/09 7 of 12 Pos, 20-70%, Gleason 4+3 Bone, CT Neg
DaVinci RP: 7/09, U of Roch Med Ctr
Path Rpt: Gleas 3+4, pT3aNOMx, 56g, Tumor 2.5x1.8 cm both lobes and apex
EPE present, PNI extensive, Sem Ves, Vas def clear, Lymph 0/13
Incont: 200ml/day ED: Trimix
Post Surg PSA: 10/09 .04, 4/10 .04, 7/10 <0.01, 12/10 <0.01
AdVance Sling 1/10/11
Post Edited (Worried Guy) : 2/17/2011 2:01:01 PM (GMT-7)