daVinci® at Lancaster General:
Offering more options for prostate, gynocological treatments
There was a time when a hysterectomy meant a woman faced 4-6 weeks of recovery. Not long ago, men required a similar amount of time to recover from prostate cancer surgery.
For most patients today, minimally invasive procedures are offered that can cut recovery time in half, as well as offer other long-term benefits.
And now, Lancaster General surgeons have another tool to assist with some of those minimally invasive procedures: the daVinci® Surgical System.
“The daVinci gives both the surgeon and the patient a different option on how to treat certain conditions that require surgical intervention, such as prostate cancer or gynecologic surgery,” says Stacey Youcis, Vice President of Operations at Lancaster General.
The daVinci is actually a robot-assisted device that allows surgeons to get a three-dimensional look at the surgical area, and is designed to eliminate tremors. The surgeon controls all movements and incisions during a laproscopic surgical procedure. Lancaster General purchased the four-armed daVinci, a recent upgrade from the three-armed model that gives the surgeon enhanced flexibility and control.
The daVinci Surgical System has a successful track record in safety and outcomes. Once the technology of the daVinci Surgical System reached outcomes comparable to existing surgical procedures, Lancaster General added it to its surgeons’ arsenal.
“The results have been at least equivalent to those of open surgery,” says David Svetec, MD of the Lancaster Urological Group, who along with Mark Jarowenko, MD, has used the daVinci for surgery since 2005. “Where the daVinci has been superior is in lower blood loss, shorter hospital stay and shorter catheter time.”
Gynocological Procedures
Thomas Fromuth, MD, from OB/GYN of Lancaster, Inc., has used the daVinci to perform several benign gynecological cases, such as hysterectomies and myomectomies.
“The daVinci allows for a truly minimally invasive hysterectomy,” Dr. Fromuth says. “As a result, it is encouraging a trend away from abdominal surgery for these procedures.”
He says that one of the benefits of the daVinci is that it is helping surgeons improve their techniques for total laproscopic hysterectomies (TLH), a procedure that involves the removal of the uterus and cervix. As a result, more surgeons are favoring laproscopic procedures over abdominal surgery, either with or without the daVinci.
Dr. Fromuth says there is actually little difference in outcomes between a traditional TLH or one performed using a daVinci. Both reduce blood loss and require smaller incisions.
The long range benefits to patients are also encouraging, Dr. Fromuth. It has the potential for additional applications, such as surgery for cervical and uterine cancer, uterine fibroids and endometriosis.
And as more doctors are trained to use the daVinci, having the surgical system at Lancaster General will allow us to attract more top surgeons to this area.
Prostate Cancer
When prostate cancer is diagnosed, there are many possible ways to approach care and treatment offered through Lancaster General, including surgery, radiation therapy, hormonal therapy, cryosurgery (the use of extreme cold to destroy cancer cells), and in some instances, “watchful waiting.”
“Some quality of life issues, such as urinary control and overall return to normal activity, have been restored more quickly after daVinci surgery when compared to traditional open surgery,” says Christopher Woodard, MD, of Urological Associates of Lancaster. Dr. Woodard and Paul Russinko, MD, of Urological Associates of Lancaster have over six months of daVinci experience.
With similar outcomes for both open surgery and laproscopic surgery using the daVinci, how can a man and his doctor determine which approach is best?
“It is an individual choice,” Stacey says. “Not everybody is an ideal candidate for the daVinci. But when you are, it’s important to trust your surgeon or oncologist to help you make the best decision for your treatment.”
Surgery using the daVinci frequently requires more time in the operating room (OR) than other surgical approaches, so a patient with medical concerns, such as prior abdominal surgery or severe lung disease, would benefit from a shorter time in the OR and might be better served by an alternative approach than the robot.
There is data out that suggests that by 2010, 60 percent of all prostatectomies will be performed using the daVinci. “The numbers are growing every year and the outcomes are improving,” Stacey says. “Every year brings more tools in the hands of the clinicians to give patients individualized options.”
“With a quicker return to normal activities and with less pain and scarring, the daVinci is growing as the preference for patients in need of a prostectomy,” Dr. Svetec says.
“We’ve had a great experience with the daVinci,” Dr. Woodard says. “Our patient satisfaction has been high.” Dr. Woodard says.
For more information related to this story: