Some of you, at least, seem to have gotten my point. What I was suggesting, is that there is not a lot of difference in quality of outcome between the highest level surgeons in New York, Cleveland, Chicago, Denver, or Seattle....to name a few major locations.
I'm reminded that one of the most experienced RALP surgeons in the US is Dr. Smith at Vanderbilt in Nashville. Not exactly a "name" location. I had mine done in St. Louis by Dr. Figenshau, who is well over the 1500 mark..and who did open surgeries for years before the robot came online. Personally, I think someone who grew up doing open and moved to the robot is automatically a better choice than someone who has never done an open surgery. My quality outcome speaks for itself.
Also, to the point that the insiders know who the good ones are, I agree absolutely. My local URO--who does exclusively open--told me that if I wanted RALP, there is only one surgeon he'd suggest with a 2 hour drive. Longer travel...he would have sent me to Nashville. I also recall the exchange I had with the Anesthesiology PA pre-surgery. She went through my chart and said, "I see you're having Dr. F for your surgery. He's the best around. If my husband needed what you're having, he's the one I'd want."
Somehow I missed all but the 1st paragraph of this post, apparently. Otherwise I'm sure I would have said :"hey, that Dr. Smith was my surgeon". I also was referred to him, 4 hours away, by my local guy who only does
opens, although his partners do robotic but not with huge experience. My local guy seemed to think Smith was one of the nations premier Gurus on the overall subject of PC. Actually, technically, I was not sent to him for surgery, but for his opinion on whether or not I would be better off with RT or RP. The actual plan was, if he recommended surgery and I went for it, I would then go either go to Birmingham or FL. He recommended that I get someone to do the surgery and check my lymph nodes,, based on his DRE and therefore his opinion that there was a pretty fair chance they could get it all
, as they say. But based on his experience(several thousand Robotics preceded by several thousand
opens) and the fact that I liked him, once I finally decided on surgery(after consulting with some RT guys over in Atlanta)I decided to go with him.
Now, ironically considering the subject of this thread, my results were no where near
as good as yours, with your less experienced guy(though 1500 is still a lot). Then again, I was a G9 with a rapidly rising PSA 10.8. And then again, he told me going in that I would have ED(probably permanent), though he did not seem too concerned about
my incontinence, which I had a lot more for a lot longer than I thought I would. At my 1st post op visit(6 weeks?) when I was still really peeing myself when up, he still seemed very confident that I would resolve, and that it might be taking longer because of my Giant prostate. I'm 90-95% OK now in that regard, though dead as a door nail when it come to ED.
PSA 10.9 ~112013
Bx on 112013 at age 64 yrs 11 months, with 5 of 12 pos with one G9(5+4), 1 PNI, T2B.
RALP with lymph nodes at Vanderbilt 021914. (nodes clear, but SV+, still G9 but down graded to 4+5, cut wide, but 1 tiny foci right at the edge of margin ) Pros. 106.7 gms!
At 15 months, not wearing a pad most days, mostly dry
PSA <.1 on 4/7,
PSA <.01 on 6/11, 8/20/14 and 3/4/15
Post Edited (BillyBob@388) : 8/13/2015 3:10:25 PM (GMT-6)