How do you choose a Da Vinci surgeon?

Hi,

As AS said it's usually the number of surgery performed with Da Vinci and should have several hundred(at least) under their belt, talk with other patients who have had surgery with them, see if you can find any ratings on web sites about their sucesses.

Also you should be comfortable with the doctor, bed side manor, ect.  You should also talk with at least one oncologist to get their viewpoint on surgery vs some form of radiation treatment.  All treatments, surgery vs radiation have side effects, some short term, some long term.

You should also have had an MRI done to map where the tumor is, so you know if it's close to the edge of your prostate or buried deep within.  Do you know what your gleason score was?  Very important in determining what treatment you should do. Agressive cancer is nothing to mess with.  Keep doing your homework..................

Dave 3+4

With radiation, the perimeter of the treatment can be extended outside the prostate, so cancers outside the prostate can be treated. Surgery is a localized treatment, and does not treat cancers outside the prostate. With a 4+3 and five of 12 cores positive, there is a posibility that your cancer may be outside the prostate.

I wonder, if your MRI used a 3.0 magnet, that is a T3 MRI, the strongest magnet in clinical use, which can provide the best image among MRI's, so you will have the best idea of where you stand.

The amercan urological association recommends  a bone scan  for those with a gleason of 4+4=8; in your ccase with a 4+3 and five cores, you may wish to discuss a possiblity of a bone scan.

Although all treatments can have side effects, surgery can have side effects with greatest significance.

First, I will say, research al of your opitions.   Not just surgery, really know what's involved in them all and then decide.

To answer your question, I had a wonderful urologist.   Worked with him for years watching my PSA rise, and a couple of biopsy's along the way.  Once diagnosed, he did recommned surgery.  He is  asurgeon as well, but performed only open surgery.   I wanted to research robotic as well.   He gave me the names of who he felt were the best robotic surgeon he knew of at his clinic, the University of Minnesota, the Twin Cites area, and the Mayo clinic.  I was hesitant to ask him at first, for fear of offending him.   His response was great.   He said "You are the star of this show and any decison you make you'll have to live with the rest of your life.  I'll help you any way I can".  So I met with two surgeons that each had done more than 3500 of these surgeries.   I ended up going to the Mayo in Rochester MN for my surgery and couldn't be happier with my results.   I was also offed a chance to join a study at Mayo, which swung my decision.   I have two sons and figured if I can help with a bit of research to assist them down the road, it was the least I could do.

I was diagnosed as 4+3, but after pathology regraded to a 3+4.

contento said:

DWL

You got good advice above. I chose a surgeon that also had done  hundreds of procedures.  However I went a bit further than that and I chose a surgeon that had also done his residency using robotics . This gave me a little more comfort that he learned from someone very skilled in the art and presumably knows how to teach that art . Most surgeons who use robotics learned after they became open surgeons and had to learn robotics from another surgeon on the fly.

Also most surgeons practice in more than one hospital. Ask him which hospital he feels most comfortable in. He most likely will have a preference.

Hope this helps -- contento

contento made an excelent point.   The surgeon is part of a team.   The team who worked with me knew what the surgeon wanted.   There was a comment by one of the assisting team about my three apppendectomy scars, he said the surgeon wanted all the arms insterted at specific angles, but he didn't think they'd be a problem.   The point being, the surgeons team knew exactly he wanted.  So if the surgeon practices at different hospitals, ask the surgeon if he has worked longer with one team than another.

DWL said:

I'm looking into HIFU and other options

I checked into CK but was told by the Doc that it wasn't good for me either due to the size of my prostate (42mL) or size and locations of lesions.  So I'm ruling out some options by process of elimination.  Someone else recommended cryotherapy because it worked for him (he said that sex is not happening but is OK with that). Now I'm looking into HIFU and have a consultation scheduled tomorrow with a local urologist who does both DaVinci and HIFU.  The radiologist's nurse has called twice asking if I've made a decision.  Leaning towards DaVinci but still undecided.  Thanks to all on these message boards.

With 5 of 12 cores positive, I don't think that HIFU is a good option. There are likely to be even more cancerous spots that would need treatment at some point. Just remember that a biopsy only samples a minute amount of the prostate ('needle in a haystack' is a good analogy).

tumor that may or may not be cancerous. The radiologist may rank these tumors on a pi-rad scale of one to five; five having the greatest cbance of being cancerous. The MRI does not diagnose,only a biopsy can diagnose.