PHILADELPHIA, PA – Prostate cancer is the
second leading cause of death among American men. It is estimated
that one in six males will develop the disease during his lifetime.
However, promising new treatment options have been developed to
help combat this threatening disease.
of the most innovative of these treatments is robotic-assisted laparoscopic
prostatectomy (removal of the prostate). The University
of Pennsylvania Health System is currently one of only
a handful of facilities across the country offering this minimally
invasive, high-tech treatment. David I. Lee, M.D.,
a national expert in robotic surgery, was recruited to Penn and
named Chief of the Division of Urology at Penn Presbyterian
Medical Center, where the robotic prostate program is based.
There are many factors that make robotics an exceptionally valuable
tool in the operating room during prostate surgery, for both the
patient and surgeon. “Perhaps two of the most-feared possible
long-term effects of a radical prostatectomy are erectile dysfunction
and urinary incontinence,” says Dr. Lee. “My specially-trained
team and I have discovered that by using the robotic technique there
is greater nerve sparing, which provides patients with the best
chance for maintaining potency and continence.”
Robotic technology offers a number of advantages during surgery.
For instance, the robotic “arms” filter even minute
tremors of the human hand so to provide steadiness. The robot’s
camera also provides a three-dimensional, stereoscopic image of
the body’s interior, as opposed to a two-dimensional image
on a flat screen. This improved perspective enables depth perception
that sharpens the visualization of the prostate and the network
of nerves and tissue surrounding it. Additionally, by scaling down
the motion of the robotic instruments, the surgeon can perform extremely
precise, intricate movements during the procedure. For example,
if the surgeon’s hand moves five centimeters, he/she can scale
the robotic hand to move only one centimeter.
Robotic technology also offers a number of advantages after surgery.
Because laparoscopic surgery is minimally invasive and no large
incisions are involved, robotic-assisted surgery provides numerous
benefits for prostate cancer patients, including: less pain and
scarring, diminished blood loss, a shorter hospital stay and reduced
recovery period for a quicker return to daily activities.
The actual robot consists of a tower that manipulates instruments
controlled from a console that is situated a few feet from the patient.
At the console, the surgeon operates four robotic “arms”
and “wrists” using hand and foot controls. One of the
robotic arms holds a tiny video camera, one works as a retractor
and the other two replicate the surgeon’s exact hand movements.
The camera and instruments are inserted through small keyhole incisions
in the patient’s abdomen. The surgeon then directs the robotic
instruments to dissect the prostate gland and surrounding tissue.
Unlike standard laparoscopic approaches that require counter-intuitive
movements by surgeons (whereby the surgeon must move his hand to
the left in order to move the mechanical device to the right), the
robotic technology affords surgeons the direct, “intuitive”
control they exercise in traditional open surgical procedures, seamlessly
translating their natural hand, wrist and finger movements at the
console into corresponding micro-movements of laparoscopic surgical
instruments inside the patient’s body.
Penn has been using fully robotic surgery for cardiac patients for
the past three years and is currently studying its use for head
and neck cancer surgeries. “The robotic prostate program is
a continuation of Penn’s commitment to finding and applying
the most precise, most beneficial surgical techniques to put patients
on a quicker road to recovery with better outcomes,” said
PENN Medicine is a $2.7 billion enterprise
dedicated to the related missions of medical education, biomedical
research, and high-quality patient care. PENN Medicine consists
of the University of Pennsylvania School of Medicine (founded in
1765 as the nation's first medical school) and the University of
Pennsylvania Health System.
Penn’s School of Medicine is ranked #2 in the nation
for receipt of NIH research funds; and ranked #4 in the nation in
U.S. News & World Report’s most recent ranking of top
research-oriented medical schools. Supporting 1,400 fulltime faculty
and 700 students, the School of Medicine is recognized worldwide
for its superior education and training of the next generation of
physician-scientists and leaders of academic medicine.
The University of Pennsylvania Health System includes: its
flagship hospital, the Hospital of the University of Pennsylvania,
consistently rated one of the nation’s “Honor Roll”
hospitals by U.S. News & World Report; Pennsylvania Hospital,
the nation's first hospital; Penn Presbyterian Medical Center; a
faculty practice plan; a primary-care provider network; two multispecialty
satellite facilities; and home health care and hospice.