da vinci question - extraperitoneal vs. transperitoneal ?

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laswell
New Member


Date Joined Aug 2007
Total Posts : 12
   Posted 9/13/2007 1:53 PM (GMT -7)   
Talked to 3 surgeons in Texas - Slawin in Houston performs this surgery w/ the extraperitoneal method. He feels this is safer because no entry into the abdominal cavity. The other 2 use the transperitoneal because there is more room and faster.
Anyone know the lowdown?
Thanks

Post Edited (laswell) : 9/13/2007 3:32:45 PM (GMT-6)


War-eagle
Regular Member


Date Joined Sep 2007
Total Posts : 219
   Posted 9/13/2007 3:05 PM (GMT -7)   

Laswell,

Glad you are with the group. I'm new, too. I had the DeVinci robotic surgery at St. Vincent's Hospital in Birmingham. It was a breeze. In one day, home the next. Cath. for 14 days. Back at work in two weeks.

I have only been on this site for a couple of days, but these people will give you all the info and, most of all, support you need.

Look around for other postings and you will find what you are looking for. You are in our prayers.

War-Eagle to all.


Age: 54
PSA 43 7/2005
Biopsy 12/14 Gleason 7 & 9
Divinci 9/2005 - spread to bladder
HT - 10/2005
RT - 10/2005 (38 treatments)
PSA 0.12 to 1.9 2/2007
Bone Scan and CT 4/2007
Casodex 4/2007
Spread to Spine, rib, and pelvis
Zometa infusions 4/2007
PSA 4.9 8/2007


Cedar Chopper
Regular Member


Date Joined Mar 2007
Total Posts : 432
   Posted 9/13/2007 3:21 PM (GMT -7)   
Laswell,

Those who have the robotic surgery with the incisions above/near the navel have camera and tools inserted into the abdominal (peritoneal) cavity and then through the internal abdominal wall, into the pubic (trans-peritoneal) cavity.
I think  - but am not certain - it is three incisions into the abdominal and two directly into the pubic cavity.   [Aside: My physicians only got just the camera through my internal wall as there were too many adhesions from prior pubic and abdomnial cavity surgeries.  Then they abandoned robotic and opened me up with a"bikni cut" into the pubic cavity - just below the navel.  (This aborted attempt at robotic was predicted by all physicians consulted - including Maten at M.D. Anderson.)]

I imagine that under certain conditions, the lack of incisions through this internal wall between cavities could significant. 
 
I wonder if the trans-peritoneal technique facilitates as much or better precision?
Less trauma?  Better healing rates?  Less blood loss?  (Time would be an issue.)  Fewer complications?  Less incontinece & E.D issues?
The experienced and respected surgeons I talked to all used the peritoneal cavity for three of five incisions.

Da Vinci is new.  This "trans-peritoneal" technique could become the standard.
Perhaps they will reduce the size of the intruments for certain areas?

CCedar
ICTHUS!


2 Years of PSA between 4 and 5.5  + Biopsy 23DEC06 
Only 5 percent cancer in one of 8 samples.  +  Gleeson 3+3=6
Radical Prostatectomy 16FEB07 at age 54.
1+" tumor - touching inside edge of gland.  + Confined:)
Pad Free @ 14 weeks.  Six Month PSA <.003  :)
At 6 months, ED treated with Pump Exercises & 50mg Viagra Daily
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