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da Vinci® Prostatectomy

da Vinci® Prostatectomy Brochure

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If you have been diagnosed with prostate cancer, and are considering surgery – ask your doctor about minimally invasive da Vinci Prostatectomy.

Why da Vinci Surgery?

With the da Vinci System, surgeons operate through a few small incisions instead of a large open incision - similar to traditional laparoscopy. The da Vinci System features a magnified 3D high-definition vision system and special wristed instruments that bend and rotate far greater than the human wrist. da Vincienables your doctor to operate with enhanced vision, precision, dexterity and control.

As a result of da Vinci technology, da Vinci Prostatectomy offers many potential benefits when compared to traditional open surgery, including:

  • More precise removal of cancerous tissue1,2,3,4
  • Ability to perform nerve sparring surgery which enables:
  • Faster return of erectile (sexual) function: Studies show patients who are potent prior to da Vinci Surgery experience a faster return of erectile function than previously potent patients who have open surgery5,6
  • Better chance for return of urinary continence: Recent studies show more patients with da Vinci Surgery have full return of urinary continence within 6 months as compared to patients having open surgery4,5,6
  • Less blood loss1,4,5,6,7,8,9,10
  • Less need for a blood transfusion1,4,6,7,8,9,11
  • Less pain9
  • Lower risk of complications1,4,7,8,11
  • Lower risk of wound infection1,7
  • Shorter hospital stay1,4,5,6,8,12
  • Less chance of hospital readmission1
  • Less chance of needing follow-up surgery1
  • Fewer days with catheter5
  • Less risk of deep vein thrombosis (life-threatening condition where a blood clot forms deep in the body)1
  • Faster recovery10 and return to normal activities12

As a result of da Vinci technology, da Vinci Prostatectomy offers the following potential benefits compared to traditional laparoscopy:

  • More patients return to pre-surgery erectile function at 12-month checkup13,14
  • Faster return of urinary continence14
  • Lower risk of complications1
  • Less blood loss and need for a transfusion1,8
  • Less chance of nerve injury1
  • Less chance of inuring the rectum1
  • Shorter operation8
  • Less risk of deep vein thrombosis (life-threatening condition where a blood clot forms deep in the body)1
  • Shorter hospital stay1,8
  • Less chance of hospital readmission1
  • Less chance of needing follow-up surgery1

The da Vinci Surgical System is used in 4 out of 5 radical prostatectomies in the U.S.15

State-of-the-art da Vinci uses the latest in surgical and robotics technologies and is beneficial for performing complex surgery. Your surgeon is 100% in control of the da Vinci System, which translates his or her hand movements into smaller, more precise movements of tiny instruments inside your body. da Vinci – taking surgery beyond the limits of the human hand.

Physicians have used the da Vinci System worldwide in approximately 1.5 million various surgical procedures to date. da Vinci is changing the experience of surgery for people around the world.

Risks & Considerations Related to Prostatectomy & da Vinci Surgery

Potential risks of any prostatectomy procedure include:

  • Urinary and/or sexual dysfunction due to nerve damage
  • Rectal or bowel injury
  • Blocked artery in the lung
  • Blocked bowel

In addition, there are risks related to minimally invasive surgery, including da Vinci Prostatectomy, such as hernia (bulging tissue/organ) at incision site.1,11

da Vinci Surgery - Treatment Options for Prostate Cancer

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  1. Tewari A, Sooriakumaran P, Bloch DA, Seshadri-Kreaden U, Hebert AE, Wiklund P. Positive surgical margin and perioperative complication rates of primary surgical treatments for prostate cancer: a systematic review and meta-analysis comparing retropubic, laparoscopic, and robotic prostatectomy. Eur Urol. 2012 Jul;62(1):1-15. Epub 2012 Feb 24
  2. Weerakoon M, Sengupta S, Sethi K, Ischia J, Webb DR. Predictors of positive surgical margins at open and robot-assisted laparoscopic radical prostatectomy: a single surgeon series. J Robotic Surg. 2011. http://dx.doi.org/10.1007/s11701-011-0313-4
  3. Coronato EE, Harmon JD, Ginsberg PC, Harkaway RC, Singh K, Braitman L, Sloane BB, Jaffe JS. A multiinstitutional comparison of radical retropubic prostatectomy, radical perineal prostatectomy, and robot-assisted laparoscopic prostatectomy for treatment of localized prostate cancer. J Robotic Surg (2009) 3:175-178. DOI: 10.1007/s11701-009-0158-2.
  4. Health Information and Quality Authority (HIQA), reporting to the Minister of Health-Ireland. Health technology assessment of robot-assisted surgery in selected surgical procedures, 21 September 2011. http://www.hiqa.ie/system/files/HTA-robot-assisted-surgery.pdf
  5. Rocco B, Matei DV, Melegari S, Ospina JC, Mazzoleni F, Errico G, Mastropasqua M, Santoro L, Detti S, de Cobelli O. Robotic vs open prostatectomy in a laparoscopically naive centre: a matchedpair analysis. BJU Int. 2009 Oct;104(7):991-5. Epub 2009 May 5.
  6. Ficarra V, Novara G, Fracalanza S, D’Elia C, Secco S, Iafrate M, Cavalleri S, Artibani W. A prospective, non-randomized trial comparing robot-assisted laparoscopic and retropubic radical prostatectomy in one European institution. BJU Int. 2009 Aug;104(4):534-9. Epub 2009 Mar 5
  7. Carlsson S, Nilsson AE, Schumacher MC, et al. Surgery-related complications in 1253 robot-assisted and 485 open retropubic radical prostatectomies at the Karolinska University Hospital, Sweden. Urology. 2010 May;75(5):1092-7
  8. Ho C, Tsakonas E, Tran K, Cimon K, Severn M, Mierzwinski-Urban M, Corcos J, Pautler S. Robot-Assisted Surgery Compared with Open Surgery and Laparoscopic Surgery: Clinical Effectiveness and Economic Analyses [Internet]. Ottawa: Canadian Agency for Drugs and Technologies in Health (CADTH); 2011 (Technology report no. 137).
  9. Menon M, Tewari A, Baize B, Guillonneau B, Vallancien G. Prospective comparison of radical retropubic prostatectomy and robot-assisted anatomic prostatectomy: the Vattikuti Urology Institute experience. Urology. 2002 Nov;60(5):864-8
  10. Miller J, Smith A, Kouba E, Wallen E, Pruthi RS. Prospective evaluation of short-term impact and recovery of health related quality of life in men undergoing robotic assisted laparoscopic radical prostatectomy versus open radical prostatectomy. J Urol. 2007 Sep;178(3 Pt 1):854-8; discussion 859. Epub 2007 Jul 16
  11. Trinh QD, Sammon J, Sun M, Ravi P, Ghani KR, Bianchi M, Jeong W, Shariat SF, Hansen J, Schmitges J, Jeldres C, Rogers CG, Peabody JO, Montorsi F, Menon M, Karakiewicz PI. Perioperative outcomes of robot-assisted radical prostatectomy compared with open radical prostatectomy: results from the nationwide inpatient sample. Eur Urol. 2012 Apr;61(4):679-85. Epub 2011 Dec 22
  12. Hohwu L, Akre O, Pedersen KV, Jonsson M, Nielsen CV, Gustafsson O. Open retropubic prostatectomy versus robot-assisted laparoscopic prostatectomy: A comparison of length of sick leave. Scand. J. Urol. Nephrol. Apr 7 2009:1-6.
  13. Asimakopoulos AD, Pereira Fraga CT, Annino F, Pasqualetti P, Calado AA, Mugnier C. Randomized comparison between laparoscopic and robot-assisted nerve-sparing radical prostatectomy. J Sex Med. 2011 May;8(5):1503-12. doi: 10.1111/j.1743-6109.2011.02215.x. Epub 2011 Feb 16.
  14. Porpiglia F, Morra I, Lucci Chiarissi M, Manfredi M, Mele F, Grande S, Ragni F, Poggio M, Fiori C. Randomised Controlled Trial Comparing Laparoscopic and Robot-assisted Radical Prostatectomy. Eur Urol. 2012 Jul 20. [Epub ahead of print]
  15. National Cancer Institute. NCI Cancer Bulletin. Tracking the Rise of Robotic Surgery for Prostate Cancer. Aug. 9, 2011 Vol. 8/Number 16. Available from: http://www.cancer.gov/ncicancerbulletin/080911/page4

All surgery presents risk, including da Vinci Surgery. Results, including cosmetic results, may vary. Serious complications may occur in any surgery, up to and including death. Examples of serious and life-threatening complications, which may require hospitalization, include injury to tissues or organs; bleeding; infection, and internal scarring that can cause long-lasting dysfunction or pain. Temporary pain or nerve injury has been linked to the inverted position often used during abdominal and pelvic surgery. Patients should understand that risks of surgery include potential for human error and potential for equipment failure. Risk specific to minimally invasive surgery may include: a longer operative time; the need to convert the procedure to an open approach; or the need for additional or larger incision sites. Converting the procedure to open could mean a longer operative time, long time under anesthesia, and could lead to increased complications. Research suggests that there may be an increased risk of incision-site hernia with single-incision surgery. Patients who bleed easily, have abnormal blood clotting, are pregnant or morbidly obese are typically not candidates for minimally invasive surgery, including da Vinci Surgery. Other surgical approaches are available. Patients should review the risks associated with all surgical approaches. They should talk to their doctors about their surgical experience and to decide if da Vinci is right for them. For more complete information on surgical risks, safety and indications for use, please refer to http://www.davincisurgery.com/da-vinci-surgery/safety-information.php.

©2013 Intuitive Surgical. All rights reserved. Intuitive, Intuitive Surgical, da Vinci, da Vinci S, da Vinci Si, Single-Site, TilePro, FireFly, Skills Simulator, EndoWrist and EndoWrist One are trademarks or registered trademarks of Intuitive Surgical. All other product names are trademarks or registered trademarks of their respective holders.

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PN 1002155 Rev A 04/2013

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