Cure rates for robotic and traditional prostatectomy are good when performed by an experienced surgeon. Data indicate that cancer removal may be more thorough with robotics, increasing the likelihood of cure. The robot eliminates much of the variability in open surgery, greatly reducing risks as compared to traditional open surgery, even when performed by an experienced surgeon.
During his extensive training and fellowship, Dr. Kella performed dozens of open and robotic surgeries. “In open cases, there are many instances in which the view of a patient’s anatomy is obstructed, especially during prostate surgeries because the area is so small,” states Dr. Kella. “For example, if a patient has a large pelvic bone, sometimes there’s just no way you can see the prostate around that bone during a traditional open-technique surgery. Before robots were available, we were trained to just remove the prostate by feel because that was our only option. When you can’t see what you’re operating on, it greatly increases the likelihood and frequency of bleeding, which is very risky to the patient. So risky, in fact, that if patients begin bleeding, our primary goal as a surgeon actually changes. We have to stop the patient from bleeding at that point, which can force a case to be completed in haste – compromising both muscle preservation and nerve sensation.”
“Having a robot with tiny little fingers that can now gently and easily travel right around that pelvic bone and give me a 3-dimensional view of the prostate is simply incredible. The precision it affords you is actually just amazing to watch – that’s one reason I recorded so many of my surgeries. Initially, I recorded them so that I could re-watch them and perfect my technique. Now I use the videos a lot to teach newer surgeons the techniques I have learned and developed over the years for different situations. It does take a really long time to become an expert at using the robot, but once you and your surgical team do, the outcomes really are priceless.”