Robotic Surgery for Prostate Cancer (Prostatectomy)
(Using the "Da Vinci" Robot for removal of the prostate)

Experience: Dr. Richard Bevan-Thomas (Dr. B-T) has been performing robotic surgery since 2002 and was one of the first physicians in the country to use both the Zeus Robotic system in addition to the da Vinci Robotic system. Currently, the da Vinci Robotic system is the only system available and Dr. B-T has made several instructional videos describing the Robotic Prostatectomy. Since 2002, Dr. B-T and his team have completed numerous robotic prostatectomy procedures in addition to reconstructive surgeries for the kidney (pyeloplasty and partial nephrectomy), and removal of the kidney (Robotic Nephrectomy). In 2007, Dr. B-T moved from Dallas Texas to Dallas, TX to join the Urology Associates of North Texas (UANT), currently the third largest robotic surgery program in the United States. He continues to perfect his ability to use a minimally invasive approach to the surgical removal of the prostate by utilizing the da Vinci surgical robot. 

Dr. B-T currently serves as a consultant with Intuitive Surgical Systems in educating the public as well as other surgeons in a clinical setting utilizing this technology.

Often, a minimally invasive approach to surgery may be used for the removal of the prostate gland and prostate cancer. This approach is called the "Laparoscopic prostatectomy".

A form of Laparoscopic prostatectomy that utilizes a robot has become the new wave of the future as minimally invasive procedures have become the forefront of technology in the operating room. The Da Vinci robotic system has dramatically enhanced the surgeon's ability to perform minimally invasive surgery with great precision and speed. Instead of the surgeon's hand entering the patient's abdomen, robotic arms are attached to long instruments that are placed through small keyhole openings in the abdomen. These instruments house a tiny camera and surgical tools that permit the surgeon to cauterize and sew tissue similar to having small hands inside the abdomen. The surgeon sits at a console a few feet away from the patient in the operating room with binocular-like lenses enhancing a 3-Dimensional picture giving the surgeon the feeling having the tissue directly in front of him. The robot also improves visualization by magnifying the surgical field by 10x. The surgeon is able to guide the robot's work by twisting his wrists in the stirrup-like handles, using his thumbs and fingers in scissor-like loops, or tapping his foot pedals to focus the camera and move the robotic arms. The Da Vinci robot simply follows the command that the surgeon gives it at the console and is therefore a master-slave system alone, not a free-standing system making its own decisions.

However, the robotic instruments, about the diameter of a pencil, have wrist-like maneuverability, allowing the surgeon to move them like his own hand, as opposed to standard laparoscopic instruments, which have a much more limited range of motion. The advanced optics allows the surgeon to view the operative field at high magnification, while maintaining a three-dimensional perspective unlike standard laparoscopic surgery.

Amazingly enough, this technology is at the forefront and is currently available for certain Urologic procedures such as the radical prostatectomy (removal of complete prostate gland), nephrectomy (removal of partial or complete kidney), and cystectomy (removal of the bladder). It is also being utilized in other surgical subspecialties such as Cardiac surgery, General surgery, and Gynecologic surgery.

Finally, the dexterity of the surgeon's hand is enhanced by the robotic system, scaling motion to allow microsurgical movements, unequaled with either open or standard laparoscopic surgical approaches.

Take a moment to watch the 3 minute da Vinci overview video

Watch this 3 minute video providing an overview of the da Vinci system. This unique minimally invasive robotic surgery technique is offered by Dr. Bevan-Thomas.
[ Watch Video ]

 

What are the benefits of a robotic prostatectomy?

Early experience with robotic prostatectomy suggests that these outcomes are at least equaled to traditional open surgery with several additional advantages. Dr. B-T routinely removes the Foley catheter 5 days after the procedure resulting in less discomfort and irritation associated with prolonged catheterization. Most patients will have an improved earlier continence and erectile function with a shorter hospital stay (24 hours on average) with less discomfort. Robotic surgery also offers the patient a reduction in blood loss during surgery with a 1% or less risk of transfusion and most patients have minimal restrictions from 2 weeks after the day of surgery.

Would I be a candidate for robotic prostatectomy?

There are many excellent options available to patients for the treatment of localized prostate cancer. Dr. B-T has extensive experience with the Da Vinci Robotic Prostatectomy and his patients are given specific instructions to maximize urinary control and erectile function before and after the procedure. Patients electing to proceed with the da Vinci Robotic Prostatectomy will be given a specific set of instructions at the preoperative and postoperative visits. In addition, patients are closely monitored via email and/or short visits to ensure that their progress continues to improve postoperatively. All of Dr. Bevan-Thomas' patients are invited into his intranet and email to maximize communication between the patient and the surgeon.

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