Robotic prostate surgery at St Vincents Hospital
A/Prof Stricker brought the first robotic prostate surgery programme to NSW at St Vincentís Hospital in February 2006. Since then over 900 patients have now been treated at St Vincentís with this technology. A/Prof Stricker has performed over 400 of these.
A/Prof Stricker is now one of a handful of fully trained robotic surgeons in Australia who performs this procedure regularly and one of 6 surgeons in Australia qualified to mentor other robotic surgeons. He is currently performing the highest case number of robotic prostatectomies in Australia and New Zealand.
A/Prof Stricker's current robotic results are:
- PT2 positive margin rate: 3.5% (all focal). These results compare extremely favourably with other major international series. 1 - 30%
- Operating time: 1.5 - 2.5 hours.
- Blood loss: Average 150mls. (no transfusions to date).
- Conversion to open operation: Nil.
- Hospital stay: 94% of patients leave by day 3 (most on day 2).
- Removal of catheter: 95% of patients have catheter removed on day 6 or 7.
- Major complications: <1%.
- Re-admission rate: 1%.
- Urinary stricture rate: Nil.
- Urinary continence rate (no requirement for a pad): 75% by 3 months and 90% by six months and 98% by twelve months.
- Sexual function rate: With nerve sparing techniques over 85% of patients have achieved sexual recovery within 12 months. Over 90% regain sexual function if under 55 years of age. These results compare extremely favourably with other major international series: 50 - 95%. And compares very favourably with traditional prostatectomy: 10 - 85%.
da Vinci Prostatectomy
Da Vinci Robotic prostatectomy is the newest and most advanced surgical option for qualified patients. This method gives a surgeon greater visualization, enhanced dexterity, precision, control and superior ergonomics. This very precise surgery only requires 5 small incisions (1cm) in the abdomen.
Dr Stricker's da Vinci DVD
Dr Stricker has put together a video on the da Vinci prostatectomy and the following is an excerpt from that.
About the da Vinci Robotic System
The da Vinci Surgical System is powered by state-of-the-art robotic technology. The System allows your surgeon's hand movements to be scaled, filtered and translated into precise movements of micro-instruments within the operative site. The magnified, three-dimensional view the surgeon experiences enables him to perform precise surgery in complex procedures through small surgical incisions.
The da Vinci System enhances surgical capabilities by enabling the performance of complex surgeries through tiny surgical openings. The System cannot be programmed nor can it make decisions on its own. The da Vinci System requires that every surgical maneuver be performed with direct input from your surgeon. The da Vinci Surgical System has been successfully used in thousands of prostate cancer procedures world-wide.
For qualified patients, there are numerous potential benefits including:
- Shorter hospital stay
- Less pain and less pain medication
- Less blood loss
- Faster recovery
- Quicker return to normal activities
- A lower rate of strictures
- 3-D visualization provides the surgeon with a true 3-dimensional view of the operating field. This direct and natural hand-eye instrument alignment is similar to open surgery with all-around vision and the ability to zoom-in and zoom-out.
- Dexterity: the da Vinci Robotic System provides the surgeon with intuitive operative controls that allows the experienced surgeon to use his open surgery skills rather than having to use counter-intuitive motions typically required by a laparoscopic approach.
- Surgical Precision: permits the surgeon to manipulate instruments with such accuracy that the current definition of surgical precision is exceeded.
- Range of Motion: the robotic instruments offer the surgeon full range of motion and ability to rotate the instruments through tiny incisions
- Ergonomics: the surgeon can sit in a comfortable position, allowing him to concentrate fully on the surgery.
- Improved Access: Surgeons perform complex surgical maneuvers through 1-cm ports, eliminating the need for large traumatic incisions.
(.wmv within zip archive, 3.4MB, Running time: 1'14")