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Information Needed on Nerve Sparing Da Vinci Surgeons

Feb2010
Posts: 51
Joined: Mar 2010

I just would like to find out for my own use and information only;
if anyone can give me names of Da Vinci surgeons who they have dealt with, and
had great results. Thanks.

lewvino's picture
lewvino
Posts: 1007
Joined: May 2009

Dr. Joeseph Smith, Vanderbilt, Nashville Tn. 2500+ Davinci and probably around the same with Open.

Larry

Swingshiftworker
Posts: 650
Joined: Mar 2010

I haven't been treated by Dr. Vipul Patel, but I did contact his office and spoke with his associates. Patel has reportedly done over 3k robotic prostate surgeries and charges $36k out of pocket for the surgery. I did not look into insurance coverage, because if I choose him or any other surgeon outside of my coverage, I'd have to pay for it myself.

I heard about him from a Kaiser urologist who saw a video of Patel doing a robotic prostatectomy during which he identified the nerve bundles (very difficult) and saved them. The Kaiser urologist tried to down play the video as being "set up" as a perfect case, but I don't think there are many surgeons who have done as many surgeries as Patel and who can locate, identify and save the nerves with such precision, regardless of their training.

However, I never spoke directly to Patel and I got the impression (unverified) that his practice is "volume" oriented and I got the hard sell from one of his doctor associates during which he downplayed the effectiveness of Proton Beam and other alternative radiation treatments, which frankly turned me off (apart from my general dislike of surgery as a form of treatment).

Doesn't mean he won't do a good job for you, but that was my general impression after reading info about him on the Web and based on a couple of phone calls with his office. However, if I ever need surgery, I will certainly contact his office again and will ask harder and more detailed questions if I need to get surgery done. That's just not the case for now.

Here's a link to Patel's website: http://www.globalroboticsinstitute.com/en/urology-robotic-prostatectomy/why-dr-patel.

bdhilton
Posts: 759
Joined: Jan 2010

My 2 cents is that I would not want a surgeon that "markets" themselves....The best real do not need to market or "hard sell" you...With regards to my biggest "turn-off" of Patel was the number of "business" awards he had won but really got me he was actually posting this as some sort of great thing...sorry I would want experience, experinece, experience with great, great, great stats....not someone who markets themselves....but that is what I believe and to each their own...

Swingshiftworker
Posts: 650
Joined: Mar 2010

Like I said, I was put off by the marketing approach of Patel's practice too, but there's little doubt about his skill. The question for me and the one I'd ask if I really NEEDED surgery would be how much time and attention he PERSONALLY devotes to each case and how much skill and care he personally would devote to planning and executing my treatment.

I met a surgeon at Kaiser who kept me waiting 40 minutes (not all that usual) but when he met me he seemed so unfocused and distracted (he even left the room to deal with another "crisis" for 5-10 minutes more) that I wouldn't trust him to be able to focus on conducting surgery on me. It also didn't help that he had ONLY 50 surgeries under his belt.

So, although we both are put off by Patel's marketing approach, there are few prostate surgeons who have Patel's experience (at least based on the numbers), I'd have to ask for more information -- including an appt to speak w/Patel himself -- before I ruled him out entirely.

bdhilton
Posts: 759
Joined: Jan 2010

When this all started for me I had Kaiser and BCBS and when my PC reared it ugly head I went outside of Kaiser...You can also appeal to use the surgeon of your choice with Kaiser (I have read of other here doing that)...I bet the surgeon was distracted with only 50 surgeries under his belt...You want experience, experience, experience with great, great, great stats...From my perspective you do not need to accept an inexperienced surgeon (and 50 is just that IMHO)….
Best to all

randy_in_indy's picture
randy_in_indy
Posts: 493
Joined: Oct 2009

My surgeon team charged a combined $18,000 the hostpital and OR room was $26,015 but my insurance only paid a fraction of it $10,997...the Da Vinci surgeon only got $3,116.14 from his 12,000 bill and the bedside surgeon only got $623.23 from his 6,000 bill. There was some other smaller bills but all total insurance only paid about 15-16K and I had met my $950 deductable for the year so I Owed $0. I am so fortunate to work for a very good privately held family company that has good medical for their employees.

randy in indy

Swingshiftworker
Posts: 650
Joined: Mar 2010

FYI, DaVinci surgery would cost me basically nothing (zero)under Kaiser or Blue Shield.

I've only interviewed one Kaiser surgeon so far and he had only done 50 surgeries. No way he's touching me with a knife -- robotic or otherwise. I have an appt to speak w/another Kaiser surgeon who I believe Has more experience. However, I'm planning to switch to Blue Shield because I'll have other treatment options (including CyberKnife and Proton Beam which are not cover by Kaiser) available to me.

Under Blue Cross, if I need surgery, I'd be able to choose a surgeon at UCSF -- one of the top rated teaching medical centers in the US -- to do the surgery and I'd probably be happy to have one of them do the surgery for free BUT if I don't get a "good feeling" about surgery at UCSF (and I can't think of any reason why I'd feel that way at this time), I'll still have the option of choosing a surgeon outside of my coverage and just pay for it myself.

Given what's at stake, I'll have no problem choosing an "out of coverage" surgeon if need be BUT, since I currently have a very early stage PCa, I view surgery only as a treatment of last resort and will NOT go that route unless ABSOLUTELY necessary.

bdhilton
Posts: 759
Joined: Jan 2010

UCSF is an excellent facility (plus my hometown) and teaching hospital...one of my uncles trained surgeons there for a number of years outside of his pratice...they have a lot of great information on their web site too...you can have faith at this facility...

bdhilton
Posts: 759
Joined: Jan 2010

I have not seen how much my insurance carrier is paying the hospital and doctors but I did get a bill from the hospital for over $38k for Operating room, recovery room, 2 day/night stay, drugs etc...$38k...Out of the $38k $32k was for the recovery room....Yes you are lucky to have such good insurance and I am blessed as well but will pay a bit more...

Feb2010
Posts: 51
Joined: Mar 2010

Randy, who's your surgeon?
Thanks.

Feb2010
Posts: 51
Joined: Mar 2010

Randy, who's your surgeon?
Thanks.

mrshisname's picture
mrshisname
Posts: 186
Joined: Feb 2010

I'll jump in here since I know the answer. Randy's surgeon was Dr. Hollensbe in Greenwood, Indiana, near Indianapolis. My husband saw his partner, Dr. John Scott. The two do the surgeries together. Dr. Scott has done 1300 procedures. I know Holensbe has done over 1000, not sure of the actual number on him. My husband will have his surgery 4/27. They do the surgery at Clarian North, in Carmel, Indiana, just north of Indianapolis. They have the same team that does all the surgeries and it is a smooth deal from admission to discharge.
Let me know if you have any more questions.

randy_in_indy's picture
randy_in_indy
Posts: 493
Joined: Oct 2009

I could not have said it any better. I think my Doc Hollensbe has done over 1200. The one part I have found out about between the two they work very well...according to Hollensbe he would not do surgery with any other person because Dr. Scott and him know exactly what each needs and does during the surgeries, one is at the console while the other is at the body bedside I believe also with a monitor and is using a fulcrum in the farthest right side port to move things around and out of the way for the console Dr. as well as changing out instruments. Their team is always the same and I believe they use two anetheselogists and are comfortable with each....mine was perfect...I had no sickness after surgery...I believe his name was Dr, Goode who you see in pre-op right before you are wheel'd into the OR.

I had a great experience. Feb 2010 if you want to email it's randy_in_indy@sbcglobal.net

randy in indy

Feb2010
Posts: 51
Joined: Mar 2010

Thanks Mrs.
Thanks Randy.
I live in Va Beach,the proximity of the treatment center was also considered. I have narrowed it down to Dr. Samadi/Mt. Sinai, NY; Dr. Patel, FL; and Dr. Shah, GA. They all accept TRICARE which is nice. Navy doctors/surgeons are great, but I don't think they could match the "numbers"-experience correlation offered by these three prominent surgeons in their field. I'm worried about air travel after surgery. Maybe I should stay close by until the cath is removed (thinking out loud), hmm. What's the average number of days before cath is removed,7-10 days? I would rather recuperate at home though. We'll see...

randy_in_indy's picture
randy_in_indy
Posts: 493
Joined: Oct 2009

BD Hilton did it from Chicago to Atlanta I believe and could tell you how it went...and that was after Open...not Da Vinci...which is pretty safe to say is less an issue in comparison.

bdhilton
Posts: 759
Joined: Jan 2010

Check him out...director of Robotics St Joseph Hospital...did a friend of mine 2 years ago and it was on CNN..goggle it and goggle him...he does not advertise his skill (he does not need too)...Best of luck

chitown
Posts: 90
Joined: Mar 2010

Will greatly appreciate any details. He is one of the surgeons I am evaluating for myself

zakpaga
Posts: 66
Joined: Jan 2010

I just have my surgery with Dr samadi, chief of the the Robotic and Minimal Invasion Division at Mount Sinai hopital in New York City. As of April 2009, he did more than 2100 robot assisted surgeries.

I am 9 days after surgery. The cathether was removed yesterday and it seems that I am completely continent. I am 52 years old, T2c and gleason 7 after surgery

His webiste is http://www.roboticoncology.com/index.php.

Good luck

07SHNNAC7081522's picture
07SHNNAC7081522
Posts: 17
Joined: Mar 2010

Zakpaga - do you currently reside in New York? I live down in Virginia...I'd like to hear your feedback (if you reside out of the NY locale...) on how your travel arrangement, hospital stay, etc., all occurred. He sounds like an outstanding oncologist.

Feb2010
Posts: 51
Joined: Mar 2010

Thank you for all the comments. We could probably add
conventional (open) surgery experts to the thread.
Maybe the web manager can create a section where we could post
names of our radiologists, physicians, oncologists, surgeons, put comments,
recommendations, etc.
********************
07SHNNAC7081522-I called Sentara and inquired about their numbers.
I did not speak personally to any of the surgeons. The urology dept mgr
told me that they have done over 600 Da Vinci prostatectomy.
Have you talked to anyone of the surgeons there yet?
********************
In situations like ours, where we are faced with a decision that will
impact us for the rest of our lives, we learn to rely, share, and help one
another. This website has brought people from all over
the country, all over the world, consoling, praying for each other.
People who have yet to meet, wish each other well, for a speedy recovery...
PC has brought shock, despair, and grief to us and to our families.
I am just glad that I found a place where we could converse, over a cup of coffee,
or tea, total strangers, and find a little bit of comfort, and assurance through this ordeal.
My family and I just want to say thank you to everyone.

zakpaga
Posts: 66
Joined: Jan 2010

I reside in New Jersey and my wife drove for an hour and half on the morning of surgery. We left home at 4:00 am and arrived at Mount Sinai hospital at 5:25am for the surgery which started at 7:25 am.

We parked the car in the garage which costs $36 a day. Hey, this is New York. My wife did not want to drive back, so she let the car in the garage, took the bus home and came back the next day before my release. On our way back, we had to stop once at a rest area so I could stretch my legs.

Wherever you choose to have your prostatectomy, remember that after the surgery, you can not stay in the same sitting position for more than 45 minutes. If you choose to take the car you can stop every hour. If it is the plane, you have to find a way to stand up even for few minutes to walk.
There is a hotel in the hospital for family members. You will have your own room and a private nurse and family members could stay with you. But it was too expensive for me at $600 a day.

Yes, Dr Samadi is one of the best Davinci surgeon in New York if not in the world (according to my primary care physician). The second is Tewary at Presbyterian Hospital. I saw both of them before deciding for Samadi who is really charming and put my wife and I at ease. As you know, it is important to trust the person who will cut you.

clrwtr
Posts: 9
Joined: Jul 2009

I had my surgery done by Dr Patel on November 6, 2009. My pre surgery gleason was 4 + 3 =7 and post op was 4 + 4 =8 with tircerary 5's. I experienced full erections within 2 weeks following the surgery and fully continent within 60 days post surgery. I have had two PSA test post surgery and they were both less than .01. I attribute this success to Dr Patel and his staff.

I was given his name by a friend who has a close relative who is one of the design engineers on the DiVinci robot as one of the top two in the world. While he does have a high volume practice the first time my wife and I met with him we spent about 30 minutes with one of his PAs another 20 minutes or so with one of the Drs training with him and finally Dr Patel spent almost 30 minutes with us. They all explained the options, their program and frankly were some of the most experienced and caring people we have ever met. Their program covers pre and post op programs in addition to the surgery.

Regarding insurance, we have Blue Cross and Blue Shield and both Dr Patel and Florida Hospital are preferred so everything was covered!

Frankly, my local urologist who is considered the one of the best in the area and has done several hundred caused more problems for me with the biopsy than I experienced with the robotic procedure by Dr. Patel. Following Dr Patels surgery I only took one pain pill the night of the surgery and had virtually no complications.

In my opinion there is absolutely no substitute for experience and I would highly recommend Dr Patel and his staff to anyone.

kurt57
Posts: 6
Joined: Mar 2010

Had my cath removed today in Dr. Patel's office. I have to tell that my procedure was pretty much what I expected after reading so many stories here. Dr. Patel is a highly regarded surgeon. I know some of you have a concern on him pressuring patients. I found that to be completely inaccurate. Dr. Patel does not need to pressure anyone into his office. He does 7 procedures 4 days a week. I would not have felt as comfortable with someone else. He was very concerned and very helpful getting us all the info that we needed.

I was told today that my margins were good, the sutures are all healing well and the cath was revmoved without an issue. I could not be happier.

I also have Blue Cross of Florida and was completely covered with my insurance.

I agree with clrwtr above in that experience is everything. Do NOT let somebody learn on you. If possible, get the best. Dr. Patel, in my opinion, is the best.

He may not give you the time that others give you, but he has good reason. His staff is top-notch. Good Luck, Kurt

ballab11
Posts: 9
Joined: Apr 2010

I too just had my surgery with Dr. Samadi and live just outside of NYC. About a 45 min drive. He is a true gem. Not only he, but his entire clinical staff and the staff at Mount Sinai. I mentioned to one of the hospital staff how nice everyone was and how much it helped my stay. Her answer was, "Dr. Samadi demands it!"

Although they have the private room for $525 a night, they let me wife sleep in a chair next to my bed. My suregery was scheduled for 4PM..arrived at 2PM. As things go I didn't get in the OR until 5:45. I was out by 7:30.

There are hotels nearby the hospital, but the catheter removal is in Dr. Samadi's office on Madison Avenue. About 40 blocks south of the hospital. I made sure to call his office at 9:01 the next day to schedule the cather removal as Dr. Samadi does 3 -4 procedures a day and I wanted in there first. I had a 10 AM appointment, got there early and Helen, his office nurse took me at 9:45.

No matter who you choose as your surgeon, go to Smadi's site and use all of the patient information and instructions. They are invaluable!

Good luck

Bruce

Speed
Posts: 3
Joined: Mar 2010

Dr. Jean Joseph at Strong Medical in Rochester, NY is one of the most experienced. He did mine and I had excellent results.

Olee's picture
Olee
Posts: 97
Joined: Nov 2008

Dr. Scott Miller at Northside Hospital in Atlanta performed my surgery. He was one of the pioneers in Da Vinci surgery in the state of Georgia. He not only performs the procedure but actually teaches as well. His surgical expertise combined with his personality,being a strong family man who showed concern for my wife and family, and an awesome staff made him the only choice. I would recommend him to anyone who is seeking robotic surgery.

chitown
Posts: 90
Joined: Mar 2010

I am atlanta based too and planning a surgery later this summer. Does Scott Miller take insurance or he is cash based only.

bdhilton
Posts: 759
Joined: Jan 2010

For robotics I would suggest Shah out of St Joe or Miller out of Northside. If you do the open procedure I would be going to Emory...all take at least BCBS

Olee's picture
Olee
Posts: 97
Joined: Nov 2008

He does take insurance, but I know for my insurance company he was out of network, even though they are a major group. It meant extra out of pocket, but I was willing to work that out for the expertise. A consult or phone call can tell you more, his staff contacted me back quickly.

txbarton's picture
txbarton
Posts: 85
Joined: Aug 2009

You mentioned Tricare. My surgeon was Randy Fagin, he takes Tricare and is in Autin, Texas. http://www.prostatecenterofaustin.com/ Randy is in the top 7 in the world for daVinci experience (the manufacturer's evaluation, not his). he just took a position as Senior Medical Advisor - Training for Intuitive Surgical, the daVinci robot manufacturer and has cut back his surgical hours so may be a little difficult to get.

Tricare means you are a vet. If you are a Viet Nam era vet you should check out: http://www.vba.va.gov/bln/21/benefits/Herbicide/AOno1.htm. VA acknowledges service in or over Viet Nam as exposure to Agent Orange and entitles you to 100% service connected and combat related disability.

Good luck.

VB

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