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Robotics make prostate surgery easier on patient Print E-mail

CMC-University doctors now perform less invasive surgeries, Robotics make prostate surgery easier on patient CMC-University doctors now perform less invasive surgeries Karen Cimino A new $1.3 million surgical robot was christened with its first four prostate surgeries last week at CMC-University. The device will help the hospital regain lost business and give patients better care closer to home, hospital officials and surgeons said.

The da Vinci Surgical System was developed by Intuitive Surgical System to allow surgeons to remove part or all of a cancerous prostate with five tiny incisions in the abdomen. Traditional surgery requires one 8- to 10-inch incision from below the navel to the pelvic bone.

The robot reduces recovery time, pain, risk of infection and scarring, doctors said. Recovery time used to be five to six weeks.

"Now at two weeks, people are going out swinging the golf clubs," said Dr. Roberto "Bert" Ferraro, a urologist who works at CMC-University.

The robotic surgery also helps preserve the two nerves that pass through the prostate to the penis. That means the men have an easier time urinating and functioning sexually than after the traditional surgery.

CMC-University got its robot in February and started using it last week, catching up with other hospitals in the area. Presbyterian and CMC's main campus began using the robot as early as 2004.

Ferraro teamed with Dr. Timothy Gajewski Thursday afternoon for the fourth robotic prostatectomy at the hospital.

The surgeons bloated their patient's abdomen with carbon dioxide and then inserted a camera through a small incision near the navel. They made four other incisions for the robot's arms and then wheeled the robot between the patient's legs and attached its arms.

Ferraro removed his surgical gown and went to the surgeon's console, which resembles a large sewing machine with foot controls. He placed his hands into the controls and his eyes over the three-dimensional viewer and began operating. The robot moved as he moved.

Gajewski stayed near the patient, holding other instruments that helped remove smoke from cauterizing and some blood so that Ferraro could see. Gajewski watched the procedure on one of two large high-definition flat screens situated on either side of the patient. The two usually switch places mid-surgery; complicated cases can take several hours.

Ferraro and Gajewski both work for Urology Specialists of the Carolinas, and their home hospital is CMC-University.

The robot is best for patients, they said, so they and other surgeons have been scheduling prostatectomies at hospitals that already have it. Urology Specialists of the Carolinas has done about 500 robotic surgeries in the area.

"We definitely lost urology volume over the last few years, and a big part of that was not having the robot," said Tony Kouskolekas, assistant administrator of CMC-University.

Kouskolekas didn't want to talk about specific numbers, but he didn't dispute those provided by the robot's maker:

Urology-related business declined about 30 percent at CMC-University -- and rose about 65 percent at Presbyterian and 20 percent at CMC -- since the two other hospitals got their robots, said Tracy Gurdak, a sales representative for Intuitive Surgical System.

Kouskolekas said CMC-University also lost other surgery business because doctors tend to schedule multiple procedures on one day and don't want to switch between a hospital that has the robot and one that doesn't.

The hospital expects to also use the robot for gynecological surgeries, Kouskolekas said.

 
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