With the advent of the da Vinci™ robot, Tulane University Health Science Center was among the first in the United States to acquire this advanced therapeutic option for management of prostate cancer. This innovative technology is equipped with microsurgical instruments and a high-resolution, 3-D camera, allowing the surgeon to perform a nerve-sparing procedure, which is the preferred technique for patients with early diagnosis of prostate cancer. In addition, this procedure enhances quality-of-life outcomes, which is a major concern for patients undergoing management of prostate cancer.
Tulane Urology, which is the only approved fellowship training site in the entire Gulf South, has surgeons on the robotic team who not only provide this state-of-the-art procedure, but they also travel extensively throughout the country, sharing their expertise and their techniques, thus teaching others this robotic-assisted approach to surgery.
Description of the Procedure
A minimally invasive surgical procedure, robotic prostatectomy uses finely controlled robotic instruments to safely perform the prostatectomy, while enhancing patient recovery and outcome. Powered by robotic technology, the hand movements of surgeons are scaled, filtered, and seamlessly translated into precise movements via the EndoWrist instruments. More specifically, the EndoWrist instruments can turn in all directions, with 90 degrees of articulation and 7 degrees of freedom, therefore providing the surgeon with improved visualization, dexterity, and precision.
After the preoperative discussion and adequate consent, the patient is given general anesthesia. Laparoscopic trocars or ports are inserted into the abdomen to introduce a 3-D camera and the robotic instruments. Additional trocars help the bedside surgeon to insert instruments, suture material, and drains. The magnification, as mentioned above, improves the vision of the surgeon and thus fosters a more precise surgical procedure, as compared to an open radical retropubic prostatectomy. Although the robotic procedure usually takes slightly longer than the open surgical procedure, due to factors such as equipment setup, instrument turnover, or change time, the benefits outweigh the extended duration. In fact, most patients are only required to stay in the hospital overnight, are sent home after having a regular breakfast, and are managed postoperatively with anti-inflammatory agents such as ibuprofen.
Since robotic surgery involves a significant learning curve, as with all new technology, the importance of experience in robotic surgery remains critical. Therefore, potential patients should seek urologists who are recognized as robotic experts who perform radical prostatectomies.
Advantages to robotic surgery include:
better visualization in 3-D
quicker return to normal activities
Lithotripsy is a noninvasive procedure that uses shock waves to break up kidney stones in order for them to be passed during urination.
Endourology is a noninvasive technique in which small telescopes and lasers are used to treat kidney stones, urinary tract obstructions, or other conditions.
Tulane Urology's Andrology and Fertility Lab and Clinic conduct research projects focused on oxidative-stress response elements and signal transduction mechanisms related to andrological issues in males, especially related to bioenvironmental toxicology, infertility, aging, sexual dysfunction, and prostate tumorgenesis.
Our faculty are experts in clinical diagnosis of vascular impotence; experts in using Doppler ultrasound; experts in manual and CASA semen analysis; and experts in assisted-reproductive techniques.
Please call 504-988-5271 to schedule an appointment with Tulane Urology.