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Prostate Cancer - Prostate Cancer Surgery

About Prostate Cancer Surgery

Surgeons who treat prostate cancer at Columbia University Department of Urology at New York-Presbyterian Hospital have three goals: first, eradicating the patient's cancer while, second, safeguarding the nerves that govern sexual function, and third preserving the nerves and muscles necessary to maintain normal urinary function. Surgeons with the most extensive experience performing prostate surgery are more likely to achieve these goals. (Our urologists first termed this triple outcome the "trifecta.")

Surgeons have together performed thousands of radical prostatectomies using minimally invasive robotic and traditional open surgical techniques. The team's experience in the full range of minimally invasive procedures is unparalleled in New York, and indeed in the U.S. Minimally invasive surgery is not appropriate for all prostate cancer patients, though. Patients who are not candidates for a minimally invasive prostatectomy can rely on our years of experience performing traditional open prostate surgeries. Department Chairman Dr. Mitchell C .Benson, Division Director of Robotic Surgery, Dr. Ketan K. Badani, are one of the few urologic oncologic surgeons in the world with extensive experience in both robotic and open procedures.

Minimally Invasive Robotic Prostate Surgery (Robotic Prostatectomy)

Members of our surgical team, Drs. Benson, Ketan Badani, James M. McKiernan, Erik Goluboff, Ben Spencer, and Jaime Landman, began performing robotically assisted minimally invasive prostate surgery six years ago and have been at the vanguard of this technologically advanced approach ever since. We have far more experience than most surgeons performing robotic prostatectomies today. Dr. Badani, Director of Robotic Surgery at Columbia Urology, has been performing robotic surgery since its inception in the U.S., and has published and lectured extensively on robotic surgery here and internationally. Dr. Badani's book, "Robotic Prostatectomy: Is it for you?" is the first book written specifically for patient in order to provide a thorough overview of robotic surgery as a treatment for prostate cancer.

Columbia Urology's urologic surgeons perform minimally invasive radical prostate surgery using a laparoscopic surgical robotic unit known as the da Vinci system. This revolutionary surgical system gives surgeons access to the prostate through a few small incisions. Miniaturized surgical instruments allow surgeons to manipulate tissue with great accuracy and remove the patient's prostate gland while minimizing harm to the surrounding tissues. The da Vinci robotic system gives surgeons a significantly enhanced magnification of the surgical field, making it easier for them to see and avoid the important nerves that run along side the prostate, greatly reducing the risk of impotence. The enhanced view also enables surgeons to more carefully dissect the apex (tip) of the prostate, thereby reducing urinary incontinence.

Columbia Urology surgeons were not only among the first in New York to perform robotic surgery, they were the first in the metropolitan area to acquire the newest robot model, the da Vinci S. This system's capacity to increase magnification gives the surgeon greater maneuverability andenhanced vision, which results in more precise surgery. Most robotic prostatectomy patients are discharged the day after surgery and have minor pain. Compared to open surgery, robotic prostatectomy offers: shorter hospital stay; less pain; less blood loss and only a very rare need for transfusion; smaller incisions; faster recovery and return to normal activity.

Studies of da Vinci prostate surgery show the benefits of this minimally invasive approach: in the hands of our urologists, robotic prostatectomy offers cancer control rates similar to traditional surgical procedures for prostate cancer and improved sexual function and urinary control outcomes.

Open Surgery for Prostate Cancer (Open Prostatectomy)

While robotic surgery is ideal for many prostate cancer patients with low and intermediate risk disease, it may not be the most appropriate treatment for all patients, especially those with very high-risk prostate cancer. Surgeons remove some lymph nodes in all prostate cancer patients, but those with very high-risk disease may require such an extended area of lymph node removal that robotic surgery is not the best surgical option. Patients with all stages and grades of prostate cancer should be evaluated at a hospital with the surgical expertise to customize the surgical treatment to your needs – and where they will have access to the full range of prostate cancer therapies. The Urologic surgical oncologists at Columbia Urology offer just such a balanced expertise.

Combined Therapy for Prostate Cancer

Men with high risk prostate cancer often require a combination of therapies – surgery to remove the prostate gland and lymph nodes, radiation, hormonal therapy, and chemotherapy. Columbia Urology's physicians work collaboratively with radiation and medical oncologists, ensuring that patients get the treatment best tailored to them. Dr Mitchell C Benson and James McKiernan are principal investigators in the Southwest Oncology Group, a national clinical research group, and are leaders in National Cancer Institute-sponsored prostate cancer clinical trials and the entire Urologic oncology team participates in these studies. Their involvement in ongoing research efforts affords patients access to the latest developments in prostate cancer treatment.