New Drug

Max Former Hodgkins Stage 3 said:

Maybe

That might have been the drug, W-M.

I have read a little on Optdivo and a related drug named Yervoy, and they are apparantly irrelevant to PCa treatment, at least at the moment. (Where are they making this stuff with these names, Russia ?) 

Did not mean to get sidetracked.

My surgery is in the morning to repair my 11 month old DaVinci incision.  Will post within a day or so to share how it goes,

max

VascodaGama said:

Max

Best wishes for a smooth procedure and excellent outcome.

A few responders mentioned here and at the other thread that surgical prostectomy incision ruptures have received very little discussion here, so a brief rehash of what I experienced might be of some interest to a few of the members.

My prostectomy was in January, this year.  DaVinci robot, by a highly experienced and well regarded urologist/surgeon  (over 900 DaVincis performed).  Healing went nicely, and there were no issues at all for about seven months. Then, I began to notice an enlargement at the main incision, which for DaVinci is apparantly above the navel, toward the sternum/center chest, or at least that is where mine is. About 4" in length. I had had a gall bladder surgery done laproscopically three years prior, in which the gall bladder is pulled literally through the navel itself. I told this to the urologist, mentioning that there would be scar tissue in that spot. It is conceivable that he relocated from the standard main-incision spot for that reason, I do not know. He did not mention any scar tissue issues post-surgery.   When discussion yesterday's repair a few weeks ago, I went over my earlier incision holes from the DaVinci and gall bladder surgeries, and he was pointing out where he would most likely enter and do the anciliary entrances for the light, camara, and gas supply.  I had not thought about it before, but obviously exactly where the cuts are made are negotiable and subject to change and relocation as the surgery progresses. My main incision yesterday is also about 3 or 4 inches, and well off to my lower left side, almost exactly stright below the breast nipple, and only a few inches abouve my belt-line.

The hernia had continued to enlarge and protrude more and more over two months until my family doc referred me to a general surgeon for repair. I had earlier called the urologist's office and spoke with his lead RN, who said that herniation there was quite rare, but when it occured, urologist send the patient to a general surgeon.  The general surgeon said that the hernia hole itself was about 2 or 3" across at the time of surgery. What was making it get larger was not an increase in the tear, but rather more contents moving out of the abdomen into the hole.

My general surgeon had a doctor who is finishing surgical residency assist on the surgery. She came in and spoke with me for some time. She said that all incisions of over around 5" done in the US herniate at a rate of 10 to 15%. I did NOT take this as a fact linked to prostectomy, but of major incisions generally.   Also, not all mild herniations require repair. I have had a hernia detectable during the "cough" test in the scrotum area for over ten years now,  which all doctors have told me does not warrant surgery, for instance.  The 10-15% estimate seems like a high number to me, but she is in current surgical training, and prepping for Board Certification, so her information should be current.  It sounded like a "cash cow," income-related fact that surgeons in training would learn.

I told her that the laproscopic gall bladder removal that I had received a few years earlier hurt like hell. I was very interested to hear her say that laproscopic surgeries do have smaller incisions, quicker healing, and cause less bleeding.  But, she stated that most laproscopic surgeries are rated as hurting WORSE than open incision for the same proceedure. I felt justified, because I had always believed that the pain following the gall bladder was severe.  She said that the inflating of the abdomen with CO2 dramatically stretched tissue beyond what would occur in open incision, and this hurts a lot afterward.   This was not what I recall the marketing of lapro stating, but it is intuitively correct and matches what I felt.  I have had over a dozen surgeries, including an 11" incision on my hip, so I know what most forms of being cut feel like.

He inserted mesh fabric under the old incision, with about 3" of extension in all directions beyond the tear.  Afterward, he showed my wife still photos of my tears from underneath (inside). She said he showed her where the navel (gallbladder) cut was also split a little, and that was corrected with the same piece of mesh.  The sutures from the fabric go through to the exterior skin tissue (I can touch and see them), so I know exactly where the borders of the fabric are.  He had told me that the cloth would mainly be secured with permanent, metallic tacking, so it is possible tthat the stitches I see were just used to frame the material in place. I will ask him when I see him on the 11th.

I am only about 24 hours off the table, and am already moving around fine without a lot of pain, but using the newer version of Loritab (Hydrocodone), so this repair experience so far has been about as mild an experienced as being cut on can be.

I will try to get electronic copies of the photos, and post here later if I can.

max

Josephg said:

DaVinci Main Incision Size

Max, I'm very pleased to read that your repair surgery went well.

I was surprised to read that your main DaVinci incision size was 3-4 inches.  Mine is 1 1/2 inches, perhaps just under 2 inches, if I stretch it out.  So far for me, there are no signs of herniation.

I can feel the reservior bulb of my artificial sphincter implant slightly (almost complete incontenance resulting from my prostate removal surgery), when I run my hand across my lower abdomen, over its location.  I will continue to monitor this area to see if the that reservoir bulb becomes more 'prevalent'.

Good luck to you on your contiunued recovery from your repair surgery.

Joseph,

I had never actually measured my main DaVinci incision, but did so after reading your response: 2.75 "

Vasco,

I kept coming up with differing guesses on how many incisions I have on my front chest/abdomen. Here is an itemization:

Gall bladder removal: 5  (One main incision, four support incisions [lights, camera, cutting tool, CO2 supply]).

DaVinci prostectomy: 4

Hernia repair: 4

Chemo cathaport: 1 (Since removed, leaving a bit of a valley. I tell kids that since I was in the Navy, it is my 'port hole'.) 2"

Biopsy incision 1  (2")

Chest tube insertions (for vacuum lines, to reinflate collapsed lung)  2

Belly drain, to drain bile from lower gut while in ICU: 1

I had a swan-ganz cath run from my groin to my heart, but cannot see the incision, so it doesn't count.

Drain lines in back, but not counting here.

It's official: 18 on the front.

Also: 11" incision on left hip to insert femur rod and wire hip socket together.  Closed left knee cap when reattaching.  Various screw holes and holes used to implant stirrups to secure left leg in traction/suspension.

.

.

VascodaGama said:

Incision repair

Max

I am glad to know that all went well with the incision repair. Your description is very informative and at the same time funny, in particular when you refer to your many “cutting” experiences. (“I know what most forms of being cut feel like”). Probably adding photographs will help in understanding the whole aspect of the healing. For the moment I only can mimic an image of you with Frankenstein style stitches around your body. (lol)

Best wishes for full recovery.

VG 

I had my prostectomy one year ago yesterday.

PSA test done today: "Undectable."  So far, so good.

max

Has anyone heard from Daytona19 ?

Last logged in March 30 of this year.

I was just wondering. Super individual with an amazing perspective.

max