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Robotic surgery for prostate cancer has made a large influence on prostate cancer treatment during the last decade. Though this type of robotic surgical technology was developed first by the United States military to be used on the battlefield, it has recently been applied to the regular medical setting; most notably it is used in the treatment of prostate cancer. The very first robotic surgery for prostate cancer took place in 2001 and now it is the most recommended treatment among American men suffering from prostate cancer. In 2009, 86,000 men in the United States had prostate cancer and an astounding 86 percent had robotic surgery.

Though the number suggests there is a robot involved, it is actually not true. The robotic prostatectomy is actually performed by a surgeon using the robotic system. It has four arms and is connected to a console the surgeon operates. One arm holds a very small magnification camera and the other three arms hold various surgical instruments. The instruments are inserted via small incisions in the abdomen approximately seven millimeters wide.

The robotic arms are able to rotate 360 degrees. This provides the surgeon with the opportunity to fully manipulate the instruments with full range of motion and flexibility. These arms rotate much in the same manner as a human wrist. Using hand movements and foot pedals, the surgeon is able to control the robot. This machine provides surgeons with a much higher degree of precision. It also removes the possibility of hand tremors and other slip ups.

The surgeon is guided using a three dimensional display of the area. By working with three dimensional images, surgeons are afforded a new perception of depth that they cannot achieve with normal laparoscopic surgery. It offers more precision and makes up for any visual feedback. These pictures offer surgeons the clarity they need to use the robotic system properly. This clarity is extremely important as it can assist in minimizing any unnecessary damage to muscles and nerve bundles along the prostate. Avoiding unnecessary damage means reducing the possible risk of incontinence and erectile dysfunction. These are two of the major side effects of regular prostate cancer that the robotic surgery looks to especially minimize.

The only criticism associated with the robotic surgery for prostate cancer and how it works is that the surgeon is unable to know how forcefully they are pulling tissue or how well the stitches in the area are holding. These items usually require what most surgeons call "tactile feedback." However, according to a number of surgeons who have used this robotic machine for prostate cancer surgery, the high quality and clarity of the visuals they get and the inherent flexibility of the robot arms definitely compensates for this drawback. Robotic surgery for prostate cancer takes often around two to three hours to complete. Patients are put under general anesthesia during the time. The majority of patients who undergo this surgical process only experience minimal blood loss. Only in less than one percent of cases are blood transfusions required.

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Ken Steliga was treated for prostate cancer at Penn Presbyterian Medical Center by David I. Lee, MD, the chief of the division of urology at Penn Presbyterian. Ken's son was also treated for prostate cancer by Dr. Lee. Now, Ken counsels men who have been newly diagnosed with prostate cancer.
Like son, like father

Following a biopsy last November, I was diagnosed with prostate cancer. I suspected that the diagnosis was inevitable, because my son had been treated for prostate cancer less than a year earlier. I figured it was coming, and it did. I made a decision to have minimally invasive robotic-assisted surgery by David I. Lee, MD, the same surgeon who operated on my son.

My son, Tim, was diagnosed at 48. I was diagnosed at 71. It’s unusual for a father to be diagnosed with prostate cancer after the son. It usually happens the other way around, but it helped me a great deal. Tim had already done all the “dirty work.” He did all the research, and that made it much easier for me.

Making an informed decision

Tim had looked at the options. It did not seem logical to have other therapies when I could get rid of the cancer once and for all. The robotic surgery made a lot more sense to me. With the two-inch incision and five small holes, I refer to my scars as “body piercing without the hardware.”

That being said, it still was an anxious moment. It’s a very serious thing. I tried to be somewhat positive. Being light-hearted about it helped me go through with the surgery. It gave me a refreshed attitude and outlook.

A positive treatment experience and recovery

The care I received at Penn Medicine's Abramson Cancer Center was excellent, and the experience was very positive. I’m a ‘type A’ personality. I’m not one to be very complimentary, and I have not always had positive health care experiences in the past. Yet, from the time that I entered the hospital, it was a very positive experience. The care that I received was excellent. It changed my opinions about health care professionals, and changed my opinion about hospitals.

It started with admissions, and the woman that admitted me was not only thorough and efficient, but she was positive and left me with very good feelings. Then, when I got up to the floor where I was prepared for the surgery, everybody that I met was positive. I was awake at the beginning in the operating room. I had a chance to chat with the men that were in there, and I could just tell by their attitudes that they were very caring. After surgery, the caring atmosphere continued to prevail. Based on my interactions with the nurses on my floor, it was apparent that they were out for my best interest and they wanted the best care for me.

The experience was very positive for me, but I realized that this is a very sensitive issue with men. They don’t like to talk about a lot of things, especially when it pertains to their sexuality. Men don’t want to talk about many of the aspects of having this type of operation. They have a lot of fears and preconceived notions about what they hear from other men. Unfortunately, a lot of it is very negative. I found that passing on my positive experience could be very helpful to other men facing this disease.

Helping other men diagnosed with prostate cancer

My positive experience is also why I have agreed to meet with Dr. Lee’s physician assistant in the pre-op classes given once a month at Penn Presbyterian Medical Center. I try to indicate to the men who are about to undergo surgery that it’s not as bad as they may think. With my positive experience, I feel very blessed and fortunate that I had this experience and I would like to see other men also have a good, positive experience.