Urology

UR Offers a Less-Invasive Prostate Procedure

(The following article appeared in the Democrat and Chronicle on April 20, 2002.)

by Matt Leingang

Robotic technology is being used during urology surgeries at Strong Memorial Hospital. The system consists of a robotic arm that performs surgeries using movements that replicate a surgeon's motions. The movements are controlled from across the room, by a surgeon using virtual images provided by laparoscopic cameras.

Richard Eisenberg knew he had two options when he was diagnosed with prostate cancer last October: radiation or conventional surgery.

But after consulting with his doctor, the 59-year-old chemistry professor at the University of Rochester was informed of a new surgical technique to remove the cancerous gland.

The technique - called laparoscopic radical prostatectomy - is a less invasive surgery, using slender instruments instead of large incisions to puncture the abdomen. Patients report less pain, faster recovery and better bladder control.

Key-hole sized abdominal incisions have revolutionized other surgical procedures, particularly for women who have tubal ligations. But because it is technically demanding, laparoscopy for prostate surgery has gained popularity only recently.

Eisenberg's surgery was in February at the UR Medical Center, one of nine academic institutions in the United States - and the first in New York - to offer the procedure.

"I believe this will become the standard for prostate surgery in the near future," said Dr. Jean Joseph, who performed Eisenberg's surgery. "It gets patients back to their normal lives much faster."

Joseph learned laparoscopy from the man who helped pioneer its use for prostate cancer in the 1990s, the French surgeon Dr. Bertrand Guillonneau.

Guillonneau visited the UR Medical Center yesterday to demonstrate laparoscopy during a video-conference including urologists and physicians throughout upstate New York.

Now, two months after his surgery, Eisenberg said his recovery was excellent. He was able to return to work in two weeks (conventional surgery would have required a recuperation of about five weeks), and his bladder control is good.

Dr. Jean Joseph uses three-dimensional visuals to perform a laparoscopic prostatectomy using a new robotic system. Seated at a console, a few feet from the patient, he uses pedals and levers to operate the robotic arms and instruments during the procedure.

"I liked the idea of laparoscopy because it is less traumatic to the body," Eisenberg said.

In general. anyone who is a candidate for conventional prostate surgery is also a candidate for laparoscopy, Joseph said. But decisions are made on a case-by-case basis.

Joseph began offering laparoscopy last August and has done about 20.

The prostate gland is a solid organ found immediately below a man's bladder and surrounding the urethra, which is the tube connecting the bladder and the penis.

Prostate cancer is the second most common form of cancer among men, after skin cancer.

In Monroe County, about 570 cases annually result in 80 deaths a year. The best way to screen for the disease is an annual rectal examination and blood test.

More information on the daVinci Surgical System and the laparoscopic prostatectomy procedure.