NEED HELP CHOOSING A SURGEON

choosing a surgeon
Johns Hopkins is one of the finest hospitals in the world. You are fortunate to have access to one of their resident physicians.

Your local urologist
How many of the two thousand were open and how many were robotic? What were his success ratios, etc.

You say nice guy, what does that mean?

Dr. Partin
I believe he authored the Partin Tables that predict the success of therapy choices when Gleason and other stats are entered...I would say he probably knows what he's doing when it comes to Prostate Cancer...but surgery...you need to get his statistics....I would think if he is wanting to perform surgery on you he is just like any other surgeon and wants to protect his results so you must be a likely successful candidate. What are your stats. ...pardon me for the questions but I myself have just re-visted the board after a lengthy time away and if you previously posted forgive me.

Randy in Indy - Still cancer free from 12-29-09 Davinci by Dr. Hollensbe and Scott in Urology of Indiana.

bdhilton said:

Hey Randy...
I have missed your inputs and wit…Yes, I totally agree ( and I understand that JHH has been accused of being very selective in the past)that like any other surgeon he wants to protect his results and is very selective…As you know I was lucky to have Catalona do mine and he is not selective (that is why his results are a few points lower than JHH)…I am finding my self here less and less as time goes on… I believe this helps many to start the healing process and accept their PCa and start to enjoy life…Good to hear you are doing well…me too-Peace

Hey BD
Good to see everyone here again....I have been very busy building my "Man Cave" two ...and the sweethearts screened in porch above the man cave. I am doing the entire thing by my self...glutton for punishment but like very much doing this by my self...it's kinda like climbing a 14teener or beyond....lots of self gratification. Just saw the urologist Thursday past and he said I was way ahead of the curve...mostly talking about the ED part....now I am almost there without any drugs and 1/4 generic viagra is all I need with my good partner. Hope all is well with you and everyone else on here I will try to check up and read some am on a road trip...Chicago today Milwaukee tomorrow and Wed. I will try to ad some helpful posts instead of this jibberish going forward...lol
Randy

choosing surgeon
I take it Dr Partin is doing is open, correct?

One of the biggest mistakes i see people make is equate a person's open experience with their robotic surgery.

Some open surgeons learn robotic surgery and do a great job, some try to learn and don't do a good job and some just never learn and find ways to highlight open surgery

There is nothing wrong with open surgery; robotic surgery has some potential advantages, but only in experienced hands. Experience isn't always in numbers. There are surgeons that have done hundreds of robotic surgeries the wrong way and are still learning and there a surgeons that have done much less, but learned it the right way (usually at a center that does a high volume); the younger physicians usually learn much easier in general.

There are fellowships in robotic surgery now and finding a surgeon trained in robotic surgery and one that has done at least 100 cases probably gives you the best chance, but again, some people are better/worse than others, regardless of training and experience.

Doing the surgery without the robot, but laparoscopically is extremely difficult procedure and one that only a few people in the world still do and do well.

Hope this helps. Look up Dr Smith at Vanderbilt; he was a big open surgeon that converted to robotic around 2003; he has written some articles on robotic vs open.

kimber45 said:

gh thanks for your response.
gh thanks for your response. I live 1.5 hours away from Hopkins.
Where did you stay a few days after you were released form Hopkins? I heard that they want you in the area for a few days. Also, who is doing your follow up work now that you are home?

Dr Pav
My surgery was at Hopkins Bay View which is just a few miles east of Baltimore. I only stayed one night in the hospital ( I could have stayed another night if I wanted to but was doing well and preferred to go home). I live about an hour from Baltimore in the DC area. I had to go for a visit/catheter removal about a week after surgery...otherwise I dont go back until my 3 month visit. If I needed to go back they were ready and willing to see me but to be honest there really wasnt a need. I did develop a blood clot in my thigh about 5 days after surgery (on a Sunday) and was able to call and discuss with Dr Pav on the phone. Had it checked out at local emergency room and determined it was a secondary vien...so no issue. Staff at Dr Pavs office are very helpful and easy to get in contact with. We found the Bay View Hospital easy to get too and were very happy with everything from admissions ( quick and easy) to the nurses on the floor to the other doctors involved in the surgery. There are hotels near by. My wife stayed in a hotel in center city the night of my surgery but wished she had stayed closer to the hospital only because it was very late when she got the hotel and she didnt need the extra driving at that point. In terms of followup, that is a question I have for Dr Pav when I see him in early Dec. I dont know what level of followup he desires and if he is ok with my local urologist performing the followup. Based on the limited surgical followup to date, I suspect that if my recovery continues without issues ( my 3 month PSA was 0 so I am hoping that there are no further complications once I get the incontinence and ED under control)the amount of followup needed will be very limited.

wk said:

choosing surgeon
I take it Dr Partin is doing is open, correct?

One of the biggest mistakes i see people make is equate a person's open experience with their robotic surgery.

Some open surgeons learn robotic surgery and do a great job, some try to learn and don't do a good job and some just never learn and find ways to highlight open surgery

There is nothing wrong with open surgery; robotic surgery has some potential advantages, but only in experienced hands. Experience isn't always in numbers. There are surgeons that have done hundreds of robotic surgeries the wrong way and are still learning and there a surgeons that have done much less, but learned it the right way (usually at a center that does a high volume); the younger physicians usually learn much easier in general.

There are fellowships in robotic surgery now and finding a surgeon trained in robotic surgery and one that has done at least 100 cases probably gives you the best chance, but again, some people are better/worse than others, regardless of training and experience.

Doing the surgery without the robot, but laparoscopically is extremely difficult procedure and one that only a few people in the world still do and do well.

Hope this helps. Look up Dr Smith at Vanderbilt; he was a big open surgeon that converted to robotic around 2003; he has written some articles on robotic vs open.

Dr Smith at Vanderbilt was
Dr Smith at Vanderbilt was my Robotic surgeon. I was very pleased with him and his staff.
The first time I met Dr. Smith I wanted to see what kind of man he truly was. Was he going to be caring, kind, aloof? After the routine questions from him to me and me to him. He asked do you have any more questions? I stated just one....I have heard numerous great things about you from other patients can you tell me something bad about yourself? He just looked at me with a smile and said "I'm sorry I don't have all day to spend with you".

I then said I'm ready to sign up for surgery. I was very impressed that he was willing to admit that he wasn't perfect.

After signing the dotted line for the surgery date his scheduler actually gave me a big hug and said Dr. Smith is the best and will take great care of you along with his staff.

First time I ever had a hug at a Doctors office. Sure beat the old finger up the rear routine!

Larry