Robotic vs Open

hi bob,

Sorry to welcome you to the forum.

There is another thread recent thread on here.

https://www.healingwell.com/community/default.aspx?f=35&m=659125


We haven't had surgery yet and are still debating the open vs. robotic, but are leaning toward the robotic, but will wait until we consult with the robotic guy on the 5th. But hopefully the other thread will help with some of your questions.

We had the same question of the guy we are considering if going for the open surgery, and he said with the small nature of our cancer on biopsy (5% in one core out of 12, there really wouldn't be that advantage of "feeling cancer". or being able to tell any different from robotic.

What are your stats? (PSA, biopsy, etc?)

Again welcome to the forum. Hope you keep us updated on your decision!

Tanya and Ken (from CO)

Hi Bob,                   Sending a special    “Warm Welcome”    to You!       This will be the hardest time for you….. but once you make your decision… the mind settles down and things start to happen in a positive way.   You are on the next stepping-stone that will take you closer to being cancer free.   Your grandfather and father have had their own personal journey with prostate cancer.   Now it’s your journey and we are happy you joined us.   Thank you for allowing us to walk with you!!!   Each journey is different, Each journey is the same….   Having friends to walk it with you will truly make it smoother.   You will have had a little more insight possibly ~ with having it in the family prior to your diagnosis…. But it is still a New Journey!   Buddy and I invite you to read our personal Thread:   Our Journey ~ Sharing is Caring We chose Radical Retropubic Prostatectomy We also watched Dr. Walsh’s 45 minute DVD on RRP.   Our urologist was able to order it free by using his letterhead with the request for one.   …It was awesome…..     Excerpt from: Our Journey (C) We had already made our decision before the Consultation Radical Retropubic Prostatectomy…..Lift the Hood …We wanted Dr. Staley to visually see and feel the tissue and take out all surrounding tissue that may be hiding… cancer cells.     Excerpt from: Our Journey KNOWLEDGE IS POWER... and POWER conquers FEAR!!!!! We decided to share "Our Journey” in hopes of helping at least 1 person!   If it helps more….   If it helps you!!!! That will truly be a blessing …   At no time are we writing to tell you what you must do, or what you should do….                                Your decision is Your Decision!! Just giving you a view of what decisions we made, what the process was for us, and the outcome as of this date.     Hope to hear from you soon…  Keep posting.... OKAY!!  Take care and know our thoughts and prayers are with you.   In Friendship ~ Lee & Buddy                       “God Bless You”   It's a little prayer   ~   "God BlessYou" ...but it means so much each day, It means may angels guard you   and guide you on your way.       Sharing ~ Our Personal Threads with You!!   updated   11-17 If you or your loved ones ~   pull “1” thing from our journey that helps you on your journey…… it will truly make our hearts happy!!!   Helpful Hint:   Click on Thread name that is underlined and it will take you directly to the Thread! Once it opens up …you may see weird symbols in the body of the post. Hit the REFRESH button to clear them…     Our Journey ~ Sharing is Caring Murphy ~ Our Special Helper A Special Note for Loved Ones (Wives, Partners, and Caregivers) Give Yourself a Second Opinion... Read this book... The hardest thing for me.... Helpful Hints for New Members... Hope this helps you! :)

Hi Bob,

I chose to have a second opinion on treatment at a university urology clinic. The advantage on going to a clinic like this is that they have several highly qualified suregons that do both the open and robotic. The first urologist I saw at this clinic did only the open and when I asked him about the advantages and disadvantages he told me that if the bipsy had shown more cancer and a higher Gleason then open would have an advanatge because of the ability to feel. In my case he felt that the robotic would be a better choice. The surgeon that did the robotic told me the same thing but he felt after having done over 2,000 of the open procedures and 800 of the robotic that the field of view and preciseness that the robotic provides gives a slightly better result for impotence and incontinence and the recovery time is much less and it is almost painless. I cam attest to the painless as I never took any pain medication following surgery other then regular Tylenol.

Hope this helps.

Tamu

Two thouhts:

I'm having the Da vinci procedure January 19, and am satisfyed with my chioce.  A friend of mine who I officiate high school basketball with had the same procedure November 1, and he is working games today.  Admittedly, he is probably on the very plus side, but had a good experience.

Second, it was good to see the response from Izzyblizzy, since he is very close to my diagnosis:  I have 1 of 10 positive at 5%, two others the infamous "atypical small gland proliferation".  At 57, my only intrepredation surrounds the fact that I'm feeling great with no symptoms, but hitting my cancer aggresively with surgery.  From a ton of reading, I am confident with my decision to rid myself of this cancer.  Even with my "small" amount discovered, I have a solid understanding that there may be more, or just what the biopsy found.  (It's like trying to hit every number on a dart board with only 10 throws!)  I don't want to take the chance and gamble with the next 30+ years of my life.  Get it out, done, and I won't have to think about it every day like I've been doing since my diagnosis. 

NBC had a recent news clip about this machine, and that solidified my choice.  While your hand can only turn about 180 degrees when you sew, the robot can go a full 360 and keep going.  I have to think I should have bought my son a video game when he wanted it so badly.  He may have been a surgeon now!!

Good luck!

I will note that I chose the UCLA robotic surgeon over a very experienced open surgeon at USC (not that the UCLA guy was not very experienced with open, and he said if he ran into problems during robotic, he'd make the switch during surgery).

The open surgery guy at USC seemed cocky about his skills, while the UCLA guy was more analytic and emphasized the need to have negative margins (while the USC guy emphasized being able to have erections and lack of blood loss). My wife disagreed with my choice, but I had to do what made sense to me. Everyone has to make the choice that makes sense to them. It didn't hurt that I went to UCLA and was very comfortable at the UCLA hospital.

Get multiple opinions (surgeons, radiologists, etc) and go with makes you feel most comfortable and don't second guess! At least as much as you can help it.

Hey Bob, Well as you can see by the responces you got this is a great place to meet people who are in your shoes as well as guys like me who have already been down the road for a while and everyone in between. I know you will make the right decision. They didn't offer robotic back when I was done so I didn't have to make that choice but must admit, I'm very happy w/ the way things turned out. I never had any problems w/ leaking at all and I started having sex 6 weeks after w/ about 60 - 70% usable erection w/ out any pills. I was never told about the penis rehab the guys are doing now, but I have to say I'm back in the game now running at about 90% w/ out any help. I don't know if it's possible to get back to 100% but I'm trying!! Good luck Brother! I'm sorry you have to be here but since you are please stay with us!
Your friend, Pete

HI BOB,       I had open Surgery at Sloan Kettering in NYC. DR Eastham said that he did 2000 of them and liked to Feel. He said that th 5 or 6  inch cut was about like the 5 or6 1 inch cuts the robotic surgery does so there wasn,t that much healing difference. I trusted Him totally and the Hospital. I would do it again tommorrow if I had to.  The cathater was in fo 11 days and the week it came out I got an erection 25mgs of Viagra and my wife just kissing.  Continence iscoming along   1 or 2 pads a day but I think it will be less very soon. I am 59  3 = 3=6   7 at Surgery T1C   2 out of 12.  Cancer Undetectable at 2 months contained in the Prostate. I like to have sex 2 a week with Viagra . M wife says I am cured.   Shepla

welcome biged,

I am sure that is something you will have to discuss with your surgeon.  Although, I would think robotic would be better indicated than open in your case, due to less blood loss.  I am guessing they will have to take you off the coumadin for any surgery though??  (it is a blood thinner right?). But I don't know. 

Were you taking coumadin when you had your biopsy?  I know they didn't even want us to take aspirin.  And Ken had just sprained his ankle two days before his scheduled biopsy and basically could only give him extra-strength tylenol cause of the bleeding risk of most of the other pain killers.

Might also want to discuss banking blood with your surgeon too.  (I think we are going to do that, just cause Ken has a kinda rare blood type).

Here is one thing i found about coumadin and surgery:

Coumadin : Elective Surgery

Coumadin® patients may occasionally face additional surgery or invasive procedures at some point in their future life. However, it is potentially dangerous to undergo some elective operations while anticoagulated. For instance, brain or eye surgery can be dangerous while on blood thinners. Even less serious operations, such as prostate or joint replacement surgery, can be associated with serious bleeding in a fully anticoagulated patient.

It is good advice to always inform your physician or surgeon that you are taking Coumadin®. Before any planned procedure, a Pro-Time should be checked to see what level of anticoagulation exists in your blood at that time. You should conference with your surgeon and ask whether Coumadin® should be temporarily stopped around the time of the upcoming operation. In most situations, a temporary stoppage of Coumadin® is all that will be needed.

http://www.hsforum.com/stories/storyReader$1515