Clinical Briefing: Robotic Prostatectomy
for Prostate Cancer
January/February 2008
Penn Presbyterian
Medical Center is among the leading
facilities in the United States offering
robotic-assisted
laparoscopic prostatectomy as an innovative treatment option in the
battle against
prostate cancer – the
second leading cause of cancer deaths in American men.
For patients, the
benefits of this minimally invasive, high-tech treatment
include less blood loss, less post-operative pain and faster
recovery. For surgeons, the technology offers enhanced visualization
of the prostate, finer hand articulation (an advantage to
nerve-sparing surgery) and shorter operative time.
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“Since 2005, the volume of robotic prostatectomies has increased
dramatically at Penn, suggesting that we are well on the way to becoming a
national leader in advanced robotic laparoscopic surgery.”
– David I. Lee, MD
Chief, Division of Urology
Penn Presbyterian Medical Center
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Case Study
Mr. A, a 50-year-old male with moderately differentiated prostate cancer,
came to Penn seeking an alternative to open radical prostatectomy. CT and
bone scans revealed no evidence of metastatic disease and he was otherwise in
good health. Following an initial consultation, Mr. A was scheduled for a
robotic, nerve-sparing procedure, which was performed several weeks later
without complication.
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IMAGE © INTUITIVE SURGICAL, INC. 2007
Robotic laparoscopic surgery at Penn Presbyterian Medical Center offers
many advantages over open radical surgery for prostate cancer patients.
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He lost very little blood during the procedure (~100 cc)
and the post-operative histology demonstrated negative margins.
Mr. A was discharged home the next day with a catheter in place. While
he experienced moderate pain immediately following the surgery, his pain
was well managed with oral analgesics and resolved within three to four
days.
Mr. A's catheter
was removed seven days after surgery, and he returned to
work two weeks later. Episodes of mild stress urinary incontinence resolved
within eight weeks. He was able to engage in sexual intercourse within
six months of the procedure, and remains disease free at one year with
a PSA < 0.1.
Our Faculty
The Division of Urology at PPMC provides care in all aspects of urologic
surgery, specializing in minimally invasive approaches to urologic problems
including laparoscopic and robotic surgery. State-of-the-art equipment and the
clinical expertise of our faculty and staff optimize the chance of full urologic
health restoration. Our goal is to meet the unique physical and emotional
needs of each patient in a caring, professional environment.
David I. Lee, MD
Chief, Division of Urology
Assistant Professor of Surgery
Dr. Lee leads the robotic prostatectomy team at Penn. Having performed
more than 1,200 procedures in a career that spans the history of the
technology, Dr. Lee is now among the most experienced practitioners of
robotic prostatectomy in the world. Dr. Lee has published over 100
articles, abstracts and book chapters in the field of minimally invasive
urology.
C. William Schwab II, MD
Assistant Chief, Division of Urology
Assistant Professor of Surgery
Dr. Schwab joined the University of Pennsylvania Health System after
completing a fellowship in minimally invasive and robotic surgery.
He has performed or participated in more than 150 robotic prostatectomies.
An author of numerous clinical articles on urology and prostatectomy,
Dr. Schwab presented the findings of his recent research at the 2007
American Urological Association national meeting.
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