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About 40 percent of the malignancies, or cancer, here at GW are urologic in nature so the urologic
oncology program is quite robust. When I left the military and came downtown and started
working here, GW was the only medical facility that was really willing to support the laparoscopic
program. And then when robotics technology came along, we looked at developing a robotics
program and they were the first in the market to really develop it in a full spectrum of
specialties, and take it to the public and show them what was available to them.
Prostate cancer is the largest percentage of patients that we care for here at GW. The
reality is that when we talk about prostate cancer, we talk about a trifecta. Cancer control.
Continence. And erections, or impotency. The hard part about it is that no matter what
approach we use, no matter what technology we use, there is a potential problem with
any one of those three. Robotic surgery has allowed us to refine the art technique so
that our trifecta rate is improved. It’s still not 100 percent but we are much improved
over earlier technology. We’re very pleased with that.
When we take the prostate out, there is a gap. The bladder then needs to be pulled down
to the urethra and that needs to be sewn together. Ideally, you want that to be watertight. When
we are performing open surgery, we are very rarely able to achieve true watertight seals
in that area. With the robotic technology, the endo wrist and the ability to place sutures
properly, we’ve been able to achieve watertight closures a majority of the time.
We’ve worked very hard and we’re able to better visualize the nerves and dissect
them off the back of the prostate. We thought initially that erections would be markedly
better because of that. The reality is that it didn’t improve as much as we thought
it would but we have found there’s been improvement. It’s a stepping-stone.
I’ll have patients coming back for follow up and say “I had such a nice experience
that I’d like to share that.” So I of course take down there name and number. When
patients want to know about how they’ve done, I gladly let them call these individuals.
They want to share. They want people to know how it went for them because it’s a fairly
scary experience for people who’ve been newly diagnosed with cancer. They want to
have that support group and to have someone that they can really talk to is extremely
beneficial to them.
Robotic surgery back in 2004 was in its infancy and that’s the first time we adopted the
technology here at GW. It was very challenging but as we gained greater experience, we came
to realize that this technology is remarkably beneficial to the patient. In fact, we have
now done well over a thousand cases here. The experience has been huge. We’ve really
become quite proficient and pleased with the results.
I think there will probably be a new technology coming down the road. The nice thing about
GW is that they’ve been very progressive and willing to invest in that technology and
it benefits the patient.
http://www.gwroboticsurgery.com/