Robotic prostatectomy is a minimally invasive, surgical treatment for organ-confined prostate cancer. When choosing robotic surgery, it is important to understand that the robot is only as effective as the surgeon at the controls. David Samadi, MD has developed an international reputation for robotic surgery expertise after performing 6,000 robotic prostatectomies using the da Vinci Surgical System robot.
There are three surgical treatment options for prostate cancer surgery: open-radical prostatectomy, laparoscopic prostatectomy and robotic prostatectomy. Dr. Samadi, uniquely fellowship-trained in all three options, performs all robotic prostatectomy procedures from start to finish and is in complete control of every robotic movement. He can expertly complete the procedure without technical assistance should a concern with the robot's performance develop.
Most robotic prostate removal surgeries last less than two hours. Procedure length can vary depending on the patient's unique prostate size, prostate cancer presentation and overall anatomy.
Ground-breaking technology, clinical expertise
To deliver extraordinary patient-centered care, Dr. Samadi offers sophisticated and modern techniques, like the use of UroNav prostate fusion biopsy system, in the comfort of his personal medical office. Dr. Samadi's office is the first in Manhattan to use this technology, which combines magnetic resonance imaging (MRI) with real-time ultrasound for visualization of suspicious areas within the prostate gland. This treatment offers unparalleled detection of high risk prostate cancer compared to the commonly offered core needle biopsy, which lacks precision and uses random sampling.
With the Samadi Modified Advanced Robotic Technique (SMART), Dr. Samadi recreates a traditional open anatomic radical retropubic prostatectomy (RRP) with robotic technology. The tools used at the center permit enhanced anatomic radical prostatectomy by improving a physician’s scope of vision. The technique also allows a physician to perform the procedure at different angles that are not possible with open or straight laparoscopic instruments.
With emphasis on quality of life after surgery, Dr. Samadi's custom modifications to robotic prostate surgery start with his approach of the prostate from the inside out. During SMART, he is constantly focused on the preservation of the urinary sphincter, the endo pelvic fascia, and the neurovascular bundles. This helps optimize sexual function and urinary control after recovery.
Unlike the 2-D perspective of laparoscopic surgery, the surgical system provides Dr. Samadi with a 3-D view of the surgical field. This advancement significantly aids his ability to spare the tiny neurovascular bundles responsible for erectile function, and it guides him as he reconnects the urethra to the bladder. Robotic surgery also requires keyhole incisions, which prevents the surgical field from being obscured by blood loss.
Dr. Samadi is able to control urethra length and reduce urinary leaking by leaving the dorsal vein complex unstitched until the close of surgery. He also protects the nerves by only using cold scissors and clips during surgery.
Short-term catheter use
Patients who choose traditional prostate surgery usually have catheters removed in two to three weeks. But with robotic prostate surgery, catheters are usually removed after one week. Dr. Samadi will remove a patient’s catheter during a follow-up appointment. He will use x-ray imaging to ensure proper urethra-bladder connection and healing.