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Prostate or Gynecological Cancer? Consider da Vinci Surgery

Finding out one has either a prostate or a gynecological tumor can be a traumatic experience for most patients, both physically and psychologically. The burning question patients have is, what options are present to remove it? This site has discussed preventative means in great depth through diet and screenings, but the actual removal of the cancer needs to be discussed.

With the advent of technology, minimally invasive surgeries (MIS) have come to the forefront for the majority of procedures, especially in the United States. If we apply the concept of MIS to tumor removal, these types of surgeries (known as laparoscopic surgery) involve the insertion of a device through a small incision, followed by excising and removing the tumor. Typically, the surgeon is able to indirectly observe the surgical area through a large display monitor. A few significant advantages of MIS include shorter recovery time, less blood loss, and less potential infections compared to conventional open surgery.

The da Vinci surgical system presents a new and innovative form of minimally invasive surgery. It was approved by the FDA in 2000. It is most commonly used for prostatectomies and hysterectomies/oophorectomies. Just for clarity, a prostatectomy involves either partial or total removal of the prostate gland. Hysterectomies can involve partial or total removal of one or all of the following: uterus, cervix, ovaries, and fallopian tubes. Therefore, the da Vinci robot has a wide variety of applications. According to the official da Vinci surgery website, some of the major advancements via the da Vinci robot are as follows:

Enhanced vision

Because the da Vinci surgical system uses 720p HD resolution, the quality of image shown is much greater compared to conventional laparoscopic surgery. In addition, the robot has three dimensional orientation, giving the surgeon the ability to see the tumor and surrounding areas from multiple angles. Finally, the surgeon can zoom in up to ten times. All of these factors lead to a more precise result. This can be of great benefit for complex surgical cases.

Mechanical wrists

In laparoscopic surgery, the device is simply a rod with an attachment. However, the da Vinci robot has mechanical wrists. These wrists mimic a human wrist by bending and rotating. As a result, there is a wider range of motion compared to laparoscopy. This gives the surgeon an added flexibility, which can lead to more precise results. According to the da Vinci surgery website, the surgical robot has special software that reduces the surgeon’s hand tremors on instrument movements.

Minimal blood loss

Because of the technicality and accuracy of the da Vinci robot, it may lead to less blood loss than laparoscopic surgery. A report by Soto et al. has demonstrated that in a study with 124 patients who required a hysterectomy, those who underwent a da Vinci surgery had “a statistically less estimated blood loss than the laparoscopic group”. As a result, less medication will need to be administered to the patient either pre-operatively, post-operatively, or both to restore a normal blood count.

What about disadvantages?

Although the da Vinci surgical system has many advantages, there are a few disadvantages as well. The two major disadvantages are cost and time. The da Vinci robot is an expensive device. According to Turchetti et al., it ranges from $1 million to $2.5 million per robot. In addition, it can be expensive to maintain. Second, many studies (Soto et al. and Maeso et al. are two examples) have stated that the surgical time with the da Vinci robot is longer than laparoscopy.

Conclusion

Overall, the da Vinci surgical system has shown promising results for removing benign and malignant tumors, especially in urology and gynecologic oncology. The advances in technology that it presents coupled with a potential better outcome for the patient will change how we approach minimally invasive surgery. Although time and cost are the major disadvantages, as a surgeon becomes more proficient in using the da Vinci surgical system, he/she will become faster at performing the surgeries while maintaining quality control. It is essential that current medical residents in surgical specialties, where the da Vinci robot may be of benefit, train using the system throughout their tenure. In doing so, when they finish their postgraduate training, they will minimize the disadvantages of the system (by achieving proficiency in residency) while benefitting the surgical patient populace. Finally, it is important for surgical candidates to consult your doctor before moving forward with any type of surgery since everyone’s case varies.

Image source

SC Ali

About SC Ali

S.C. Ali is an author/editor. He has a degree in Chemistry, and is interested in the study and practice of medicine. His blog can be found here: http://thebronzelifestyle.com/

SC Ali

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