Who are the best Kaiser Bay Area (CA) daVinci robotic surgeons ?
Looking for a surgeon ideally with lifetime 500+ daVinci robotic radical prostatectomies.
The surgeon would also be current doing 100+ daVinci robotic radical prostatectomies per year.
The learning curve for the daVinci robotic machine starts to plateau around 400 - 500 radical prostatectomies lifetime.
I wonder is there any Kaiser location with this kind of volume for a robotic radical prostatectomy specialist as practice makes perfect if one is skilled and determined.
Comments
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surgical margins
You can ask what surgical margins the doc has achieved; the less the better. I spoke with a surgeon who with MRI guided equipment had a surgical margin of 0.06. The world class docs, without MRi guided equipment, a few years ago were achieving from about .09 to 0.18
If you wish, to provide the details of your case, we can comment on what we believe to be the best treatment with the least side effects.
Best
H
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Who Knows?
No one I spoke to 5 years ago at Kaiser in SF and Oakland had more than a 100 or so DaVinci prostate surgeries under their belt. That number should have gone up by now but most of the DaVinci surgeons that I spoke to did not specialize in just prostate surgery only; they did a variety of different surgeries. So, you should ask them specifically how many DaVinici PROSTATE surgeries they have done (as opposed to DaVinci surgeries generally).
There is no "master list" of Kaiser doctors who perform DaVinci prostate surgery. So, all you can do is interview the urologist/surgeons who are currently practicing where you want to be treated. You can get a list of them off of Kaiser's "find a doctor" site.
The other problem is that there is no standard method of reporting the results of such treatments. Any surgery that does not result in a recurrence of the cancer w/in 5 years is considered a "success" even if the patients suffered serious ED or incontinenece issues. However, the surgeron should be able to tell you how many of the prostate surgeries they did which were success or failures. You should also ask for references from patients who they have treated -- both succes and failures. If they can't do that, I'd steer clear of them.
BTW, after much research, I decided to forgo surgery and went w/Cyberknife SBRT treatment at UCSF instead. This was over 5 years ago and I do not reget the decision. I had to quit Kaiser to do so, since it did not use CK to treat prostate cancer at that time BUT I understand that they now use CK to treat prostate cancer at the SSF location. You should investigate that as an alternative method of treatment. Brachytherapy treatment of prostate cancer is done in Roseville but between BT and CK, CK would (IMHO) be the way to go.
Good luck!
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Surgeons
Jronne,
I had DaVinci in January, but in a different part of the country. My urological surgeon has done over 900 prostate removals. Dr Scardino of Sloan Kettering says in his Prostate Book (I believe I am remembering this correctly) that DaVinci proficiency is usually achieved by around 400.
I will say that even with the seasoned veteran surgeon that I had, the pain was SIGNIFICANT. After eight months, normal spontaneous sex still seems a distant dream. My main incision is now herniated, and may require surgical repair (I should know in a week or two; surgery might not be recommended). Numbers alone do not prove a doctor is better than one who is less of an assembly-line sort of guy.
And do not expect DaVinci to be easy, even if it is easier than open incision. I would review all treatment options in some detail before making a final decision; at a minimum, speak to a well-regarded radiation oncologist first. I did, but chose the surgery instead. I do not "regret" my choice, but do ponder at times if radiation (I was considering IGRT at 76 Gr) might have had me happier at this point.
The most important thing however is eradication of the cancer, and if there are no indications that the cancer has escaped the gland, then surgery is very often a good choice. Very generally, if there is spread outside the gland, surgery is less likely to be a good first-line approach.
max
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