"New Technology- Robotic
Prostate Surgery minimizes blood loss and promotes early recovery in patients
undergoing radical prostatectomy for prostate cancer"
Recent NEWS WEEK Article- please read
NEWS WEEK Article
Comparison of various surgical treatments
Pooled Analysis of
Published data
Nerve Sparing Technique
General overview
Advance Robotic techniques of Prostatectomy (ART)
Robotic prostatectomy has become an important modality in management of
prostate cancer. We have been involved in refining and developing advance
techniques for meeting key goals for prostate cancer surgery. Dr. Tewari
organized a symposium in New York last year which described these techniques.
What are the key goals for treating prostate cancer:
a) Cancer control
b) Urinary functional recovery
c) Recovery of sexual function
Dr. Tewari has been involved in refinements involving all key areas
of Robotic Prostatectomy.
Cancer control- He has implemented an Individualized program
of Oncologic optimization (IPO). This program focuses on key
preoperative and operative measures for reducing the margin positive
rates. With this strategy he has been able to reduce the margin
rates to less than 3% in last 100 cases.
Urinary function recovery- This is a challenging problem and
few patients may suffer for more than 9-12 months, we have been able
to develop few modifications such as Pubo-prostatoplasty for early
recovery of urinary function. With this modification,
approximately 60% of patients are achieving 0-1 pad status in few
weeks and another 35 % may take additional 3-9 months. .
Patients who are obese, have large prostates, suffer with night time
frequency, voiding issues, fat around the bladder (pelvic lipomatosis),
neurologic issues, bladder diverticulum and who require wide resection
of tissue (due to more extensive cancer) may have delayed recovery.
Sexual function recovery- Dr. Tewari performs tri-zonal
athermal nerve sparing using minute clips and data from extensive
studies in Dr. Tewari's laboratory. It is important to note that
not every one is a candidate for nerve sparing and there are few
patients (based on their cancer characteristics) who may require
varying grades of nerve sparing. In patients who undergo
bilateral athermal nerve sparing, early data (at 6 weeks) is promising
and approximately 43% patients have erections firm enough for
intercourse or masturbation and at 6-9 months that number grows to
approximately 80%.
These technical modifications have been presented in several
publications, meetings and video's.
For reprints please call 212 746 5643 or e mail
Robotic
Coordinator
