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“Robotic surgery is gaining greater exposure and acceptance by producing excellent outcomes.” —Howard Winfield, M.D.
When physicians mentioned the possibility of removing his cancerous prostate using new laparoscopic/robotic technology, Michael Finnin was apprehensive.
“When it comes to surgery, I would rather have it done the way they’ve done it a thousand times versus a hundred,” he says.
But Finnin was sold on the potential benefits—the robotic procedure is less invasive and may require less “down time” than traditional surgery—so he forged ahead to undergo the sophisticated operation at University of Iowa Hospitals and Clinics.
Finnin, 57, who owns a car dealership in Dubuque, Iowa, had experienced no real prostate cancer symptoms and might owe his life to an annual physical.
“Dr. Kristin Nelson at Dubuque Internal Medicine (a 2000 graduate of the UI Carver College of Medicine) noted I had an elevated PSA level (cancer can increase prostate-specific antigen levels). She referred me to Dr. Thomas Holt with Dubuque Urology Services, who did a biopsy and found the samples cancerous. I decided the best thing was to remove my prostate,” Finnin says.
Finnin was diagnosed with adenocarcinoma, a malignant tumor originating in cells that have glandular (secretory) properties. One treatment option, radical prostatectomy, involves removal of the prostate gland and some of the surrounding tissue to prevent the cancer from spreading.
Next for Finnin was a consultation with Richard Williams, M.D., head of the Department of Urology at The University of Iowa. Williams and members of the Holden Comprehensive Cancer Center concurred that surgery would be a good option and broached the idea of using the da Vinci® robotic surgical system, noting that his colleague, Howard Winfield, M.D., director of urologic laparoscopy and minimally invasive surgery, has successfully performed dozens of complex operations using this technology.
In laparoscopic surgery (which Winfield calls a “kinder, gentler form of surgery”), physicians use miniature instruments that are inserted into the patient through pencil-sized incisions. Potential benefits applying to prostatectomy include:
- Decreased blood loss and decreased probability of blood transfusions
- Potential for improved preservation of continence and sexual potency through a more precise procedure
- Earlier return to normal physical activity
- Decreased post-operative pain and improved cosmetics
The patient criteria for radical prostatectomy using da Vinci are broad. “Mr. Finnin was an ideal candidate because he is young (the procedure is usually performed for men under age 70) and needed curative therapy for localized prostate cancer,” Winfield says. “In doing these procedures, we simply place laparoscopic ports (holes) through which the da Vinci’s robotic instruments pass.”
The system allows surgeons to operate from a distance without actually touching the patient. Instead, the physician sits at a computer console that offers a
three-dimensional, magnified view of the delicate tissue in the operating field (a second surgeon assists and exchanges instruments as needed).
When the surgeon moves the controls to the right, the robot’s instruments move in tandem, giving the surgeon natural hand-eye coordination. The robot’s “wristed” instruments mimic the movements of the surgeon’s hands and wrists.
“The prognosis for Mr. Finnin is excellent,” Winfield says.
Finnin says a quick return to work was important. “After the operation, I was only in the hospital two days. After about 10 days, the catheter was removed, and within days of that I was working on a limited basis. Thirty days out from the operation, I traveled to Michigan to play golf. I would definitely recommend the procedure to anyone who needs it.”
For more information about laparoscopic prostate surgery, patients may call UI Health Access and ask for the Urology scheduling office or call the office directly at 319-356-2421. For consultation and referral, physicians should contact UI Consult. |
