CSN Login
Members Online: 3

Open Surgery verses Robotic

Evagirl's picture
Evagirl
Posts: 60
Joined: Mar 2010

I read the "Surgery" thread and it seemed
as though more men had continent problems with the
open surgery...or maybe it was my imagination

I dont think Most of the men said what kind of surgery they
had though on that thread though...

Does anyone know where I can find statistics to compare results on both types?

And has anyone wavered back and forth on decisions like I seem to be doing?

Oh my this is one heck of hard decisions~~

Evagirl's picture
Evagirl
Posts: 60
Joined: Mar 2010

On a few threads I have seen men post some stats like what kind of surgery,procedure or treatment they had.

that would be so helpful if they did that sort of like a signature line..that would
be there every time they posted...that way we would link the results of their surgery with the type of surgery and we would get to know which type each person had...
just a suggestion..after all I am just a newby here....
~~ Eva

hopeful and opt...
Posts: 1398
Joined: Apr 2009

there was a study of about 30.000 men who had a robotic or open prostectomy
complications
general cancer in prostate positive margins

robotic 6.6 10.3
open 10.3 18.3

anyway positive margins are significantly higher for those getting open.

Ira

Evagirl's picture
Evagirl
Posts: 60
Joined: Mar 2010

Ira

do you know if this study was done on men in the last 5 years?

also when yu say positive margins...so you mean that the cancer was

spread more in the men who had open? why would that be? Was it because

the men who had open were more advanced to begin with possibly?

I am trying to figure out why the positive margins would be different

because of the method of surgery???

Also did the study break it down on the type of complications?? and if they

were minor or significant?

bdhilton
Posts: 759
Joined: Jan 2010

I would say that is what you are choosing to perceive right now… I was continent the moment they pulled the cath from me and I had the open process…As of yesterday I am walking over 6 miles a day (3 weeks 2 days after surgery), I am having partial erections and have had an orgasm… From my review experience of the surgeon is the number one determiner of the out come coupled with your cancer grade and where the cancer actually is situated in and around the prostate. Da Vinci from my perspective and research is not a magic bullet it is an extensive surgery just like the open process plus if the “robot” breaks down during the procedure the surgery will have to do an open procedure…. If you are debating between the 2 surgical processes look at experience (along with excellent stats) ….and at the end of the day there is a degree of luck with the out come…

Best of luck

hopeful and opt...
Posts: 1398
Joined: Apr 2009

findings which included all types of hospitals, experienced and inexperenced surgeons, various locations that reported, as I would guess not statistically valid.

Positive margins, the cancer was spread more in men who had open...this surgeon believes that shows the robotic method to be better, eventhough advocates of open say that they can feel the prostate to get better results.

Complications: I have trouble reading my notes, but this is what I have.

mean complication,
general population all types, significant
and non signiicant
robotic 6.6

open 10.3

sorry that my notes are not very good.
Tra (?)

robotic 2.9
open 24.0

continent 3 months
robotic 73-91%
open ?

bdhilton
Posts: 759
Joined: Jan 2010

From what I have read from University studies is that Robotics is “marketed” to appears a better process but the reality of recent studies shows that robotics patience have a 30% higher rate of positive margins…At the end of the day it is the experience of surgeon for the better outcome… I would be wary of a “lecture” providing “neutral” facts of something that they are “selling”…To each their own but again it is the experience and success of the doctor that helps in the final outcome plus a degree of luck to be realistic… That is my 2 cents

Swingshiftworker
Posts: 669
Joined: Mar 2010

FWIW, I don't believe ANYONE should resort to surgery of any kind for prostate cancer unless his life depends on it, because the risk of ED, incontinence and surgical complications are too great given the availability of other less draconian radiation alternatives.

However, if you are going to choose to do surgery, there is evidence that robotic surgery presents greater risks than open surgery.

See: http://www.prostatecancerfoundation.org/site/c.itIWK2OSG/b.5528483/k.8268/Impotence_Incontinence_Risk_Casts_Doubt_on_HighTech_Prostate_Surgery.htm.

Why? It seems it's mainly due to the INEXPERIENCE of the surgeons using robotic surgery for prostate cancer. As the article suggests, anyone with less than 150 surgeries is just "experimenting" on the patient. So, if you do choose robotic surgery for your cancer make sure that the surgeon has as many surgeries as possible (preferably in the THOUSANDS) before you choose him (or her) to cut you open to take out your prostate.

Best wishes and good luck!

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

Please respond back and tell me how you can tell, as you say, "if ones life depends on it" I would like to know how you determine that, What exactly is your criteria for determining that?

Randy in Indy

Swingshiftworker
Posts: 669
Joined: Mar 2010

For me, "if my life depends on it," means an intermediate or advanced stage of prostate cancer (Gleason 4,3 and Stage T2 or higher) likely to metastasize and extend beyond the prostate or that has already extended beyond the prostate, which requires immediate removal to prevent further advance of the cancer to the rest of the body.

I'm at Gleason 3,3 and Stage T1c and only 1 out of 10 cores w/only 0.6 mm involved, the lowest level, which gives me all kinds of options that I plan to explore and use before even considering surgery. However, if the cancer advances unexpectedly and "if my life depends on it" I will resort to surgery and hope for the best, despite my knowledge of the substantial risks associated with it.

I know that you do not share my concern over the risks because of your fortunate results, but I may not be that lucky and don't want to subject myself to the risk of such misfortune unless ABSOLUTELY necessary and that means unless "my life depends on it."

Ciao!

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

HOwever...if you read my stats...I was a gleason 3+3 in all three of the right side samples of 8 samples...my prostate was small...only took 8. Involvement was only 20% 10% amd 10% But then wait...after it was removed..wham...turned out to be:

1. In both sides
2. less than 1mm from breaking through the outer capsle
3. Grading changed to all 3+4=7
Primary Pattern 3, 80%
Secondary Pattern 4, 18%
Tertiary Pattern 5, 2%
4. Plus

Tumor Quantitation:
Greatest Dimension, Largest tumor focus: 19 mm
Additional Dimension 18 x 15 mm
Location, largest tumor focus: Right posterior quadrant
Multifocality: Yes
Greatest dimension second largest focus 10 mm
Location: second largest focus: Left Posterior quadrant
Extraprostatic extension: Yes

So.... do you Really KNOW difinitively what your cancer is staged at....? After all the reasearch I have done...I would say ...YOU CANNOT KNOW...becaues ...an undisputable fact remains the biopsy results usually are much less than the reality.

I do so wish you the best of luck in getting a cure..but please do not feel what the docs have told you from a biopsy and or other tests MRI Coil etc ...are exactly what you have. Just another reason to remove the problem...then you have (a more definitive) analysis of the tissue.

Subscribe with RSS
About Cancer Society

The content on this site is for informational purposes only. It is not a substitute for professional medical advice. Do not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Please consult your healthcare provider with any questions or concerns you may have regarding your condition. Use of this online service is subject to the disclaimer and the terms and conditions.

Copyright 2000-2015 © Cancer Survivors Network