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Teaching Hospital Food for Thought

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

Surgeons learn more by doing than by watching so they are given every opportunity possible to "do" while in training.

When surgery is done at a teaching hospital there are high odds that the procedure will actually be done by a resident or fellow with oversight by an "attending" surgeon.

To me it is very important to ask the surgeon who specifically will be doing the surgery, not who is responsible, who will actually do the cutting.

Another piece is that attending surgeons add procedures done by residents or fellows to their CV so when a surgeon at a teaching hospital reports thousands of procedures in his experience the number actually done by him will be significantly lower.

The daVinci robot was approved for prostatectomy in May 2001. A reasonable workload for a surgeon is 200-250 surgical procedures/year. At that rate it will take a surgeon 10 years to achieve 2,000-2,500 procedures; 5/week/year. Keep that in mind if your surgeon reports thousands of procedures worth of experience, especially if he also does procedures other than robotic prostatectomy.

This is nothing against teaching hospitals, just something to think about and clarify with your surgeon before you start counting backward from 100.

VB

marc1957
Posts: 79
Joined: Oct 2009

Good thinking here.

When I spoke with my doc, he does two on tuesdays, thats it, no more, sees alot of patients the rest of the time, and his partner does all the open surgeries.

My doc was in the upper 180's when I spoke with him, was closer to 200+ when I had mine done.

Do the math, he was in his 3rd full year, and had completed 180 of them with the Da Vinci.

My surgery lasted 4.5 hours, and was according to the doc, one of the better ones, went extremely well.

I am happy with my results, and havent heard any complaints about him (yet).

-marc

ballab11
Posts: 9
Joined: Apr 2010

Hi Marc,

I'm glad you're well now, however 4.5 hours with a Da Vinci seems rather long. My doctor, Dr. David Samadi of Mount Sinai in NYC has done literally thousands and he is a leader in the field. They put me under at 5:50 PM and my wife received a call from him at 7:10 PM saying he was done. All went extremely well.

Dr. Samadi probably does 10-15 surgeries a week. He made sure to tell my wife and I that he would be the only one at the console. Mount Sinai is a world reknowned teaching hospital, however Dr. Samadi runs a very tight ship.

I suggest that anyone and everyone having a Da Vinci look at his website, whether you use him or not.

http://www.roboticoncology.com

Be well,

Bruce

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

This is precisely why one of the surgeons we visited was knocked off the list. He told us that the 'fellow' would do part of the procedure, but that any parts involving the nerves would personally be done by him. Well, my hubbie reasoned that with the small size of the prostate, just how much would the fellow be doing and how much the surgeon? We also did not like the idea of him being in a teaching hospital and the room for errors there - I was in a car wreck 12 years ago with a badly shattered femur - the fellow put my leg back together crooked! That was enough of a turnoff for us, as to being in a teaching hospital. I know that they have to learn somewhere, but not on my hubbie!

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