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History of Stanford and Robotic-Assisted Radical Prostatectomy

Technology developed and perfected here at Stanford University was crucial in the development of the Da Vinci surgical robot. The purchase of the Da Vinci robot by Stanford University Medical Center in 2003 made it one of the first medical centers in the nation to embrace this new technologic advance to the treatment of prostate cancer. There are 3 urologic surgeons who are fellowship trained in minimally invasive techniques and experienced in the performance of robotic prostatectomy, Benjamin I Chung, Harcharan S. Gill, and Mark L. Gonzalgo, MD, PhD.

About the Da Vinci Robot

The Da Vinci robot is manufactured by Intuitive Surgical (Sunnyvale, CA) and has been utilized for robotic prostatectomy since the late 1990’s. It is a sophisticated instrument that offers both the surgeon and the patient numerous advantages, which are listed below. The robot has enjoyed increasing popularity and it is estimated that in 2007, approximately 40% of all radical prostatectomies performed in the United States will utilize this robotic technology.

The Advantages of Robotic-Assisted Prostatectomy

Robotic-assisted surgery uses cutting edge technology to allow our surgeons to perform this delicate procedure. The robot allows the surgeon to have a three-dimensional (3-D) view of the surgical field, at a greatly increased magnification, up to 15 times greater than the human eye. Fine articulating instruments, under the command of the surgeon, are used to precisely remove the prostate and preserve the nerves responsible for maintaining erectile function. Because of the utilization of robotic technology, the surgery can be performed using very small incisions, greatly decreasing recovery time and blood loss, and hastening convalescence. This allows for patients to return to their daily lives with a minimum of inconvenience, despite having undergone major surgery.

How It Works

The da Vinci robot is under the direct control of the operating surgeon. The surgeon sits at a console specifically designed to allow for total control of the operation. The surgeon looks into a binocular eyepiece system that allows him to view the surgical field under 3-D vision. The instruments, which are placed through small port site incisions, are maneuvered with hand controls that allow the operating surgeon extremely precise and fine control. These “wristed” instruments are designed to allow for 90 degrees of articulation and 7 degrees of freedom, which is more than the human hand is capable of performing. The prostate is detached from its surrounding structures and, when possible, the nerves controlling erectile function are delicately preserved, using the above technology.

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