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Prostate Cancer Surgical Outcomes Optimized by Combining Open, Laparoscopic, and Robotic Surgery Methods


December 16, 2011 - NEW YORK, NY

A robotic surgical system mishap in Mumbai, India this week caught the attention of prostate cancer specialists and patients worldwide. Due to a rare "hitch" in the robot's functioning, surgery was halted just prior to incision, requiring the team to awaken the patient from anesthesia with his cancerous prostate still intact. Surgeons at the Asian Heart Institute attempted to restart the robot to no avail and subsequently concluded the prostate cancer surgery.

Dr. David Samadi, Vice Chairman, Department of Urology, and Chief of Robotics and Minimally Invasive Surgery at The Mount Sinai Medical Center, uses a similar da Vinci surgical system and has never experienced such a problem, though he believes with a greater breadth of robotic surgery experience the interruption could have been avoided. "I know the da Vinci robot to be incredibly reliable; however," he continues, "it's important to remember that the robot is a surgical tool and is not intended to replace the abilities or on-the-spot judgment of an experienced surgeon."

Robotic prostatectomy is a preferred treatment for the surgical removal of localized Prostate cancer. Using his own SMART (Samadi Modified Advanced Robotic Technique) Surgery, Dr. Samadi employs the robot's precision, dexterity and magnification to expertly remove the cancerous prostate, preserving the surrounding nerve bundles that control urinary and sexual functions. To date, he has successfully performed over 3,600 robotic prostate surgeries.

Attributing his success to a "3-in-1 approach, three surgeons in one head," Dr. Samadi is one of few urologic surgeons worldwide with fellowship training in open surgery, laparoscopic surgery and robotic surgery. "The robot enhances the procedure, but my surgical experience across all three modalities is what provides me the upper hand against Prostate cancer," he says.

Further, Dr. Samadi believes a good part of the success in beating Prostate cancer comes from the visual and tactile input during surgery. "Pre-surgery testing only tells us so much. During surgery, the robot can only do what the surgeon directs. I give that direction based on what I see during surgery and what I apply from traditional surgical principals."

Dr. Samadi's wants Prostate cancer patients to rest easy. "We have never had the robot fail during surgery, but should it I can complete the procedure with open or laparoscopic surgery. I assure patients I will be in control of their surgery from start to finish and I will do everything in my power to remove the cancerous prostate as planned," he affirms.

Robotic surgery is in its infancy internationally and Dr. Samadi works extensively with surgeons in Israel, Dominican Republic, Netherlands and other countries, facilitating the successful integration of robotic technology. "The robot does great things," says Dr. Samadi, "but the true measure of its benefits are not immediate. A skilled surgeon must have a strong surgical foundation and build their precision with the robot over time." Dr. Samadi's international efforts aim to prevent negative outcomes such as the one experienced in India this week.

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