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Jan 07th
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New technology improves prostate surgery Print E-mail
Dr. Joel Rosenfeld describes procedure to Squires & Stags

By Ray Bowyer
Joel A. Rosenfeld, M.D.
Joel A. Rosenfeld, M.D.
Prostate surgery has had a recent major step forward, according to the talk by Dr. Joel A. Rosenfeld at the November meeting of Squires and Stags. Dr. Rosenfeld is a graduate of Georgia Tech and the Medical College of Georgia. He is an associate of Georgia Urology, with an office in Jasper.

The tool which has made the step forward possible is the da Vinci Surgical System, a product of Intuitive Surgical, Inc. This tool provides three or four arms (at the option of the hospital) which function as the surgeon’s hands as he or she performs surgery.
The surgeon works at a console a few feet away from the patient, where he or she is able to watch the surgery through a video link, while controlling the arms to cut, cauterize, and suture the patient. Some of the benefits of using this tool over previous procedures are the following:
  • Several very small incisions, in place of one large incision.
  • More precise control of cutting.
  • Less pain.
  • Less blood loss.
  • Lower probability of negative side effects.
  • Quicker recovery from surgery.

A drawback of using the new tool is that the total surgical time, including setting up the tool, is longer than traditional surgery. Dr. Rosenfeld performs the traditional procedure in about 1 ½ to 2 hours, and takes about 2 to 2 ½ hours with this tool. Another drawback is the cost—the tool costs about $1.5 million.

The characteristics of prostate surgery that make it difficult are the large number of blood vessels, and the presence of the urethra and bladder, which must be protected from damage.

Dr. Rosenfeld found the new tool difficult to learn, but finds it very intuitive to use now that he is used to it. He learned by working with another surgeon in his practice, first observing and then using the tool himself for a gradually-increasing portion of the surgery.

Dr. Rosenfeld provided the attendees with the somewhat dubious pleasure of watching a video showing an actual prostate removal using the tool. No one volunteered to try using the tool.

Dr. Rosenfeld provided the following information in response to questions:

  • The PSA (Prostate Specific Antigen) diagnostic tool is not perfect, but it is the best we have. Researchers are investigating other diagnostic tools which might be better.
  • One third of biopsies (performed when screening indicates a possible tumor) are positive.
  • There are no symptoms of prostate cancer at the stage where it can be treated with good results. By the time symptoms appear, the cancer has spread.

Squires and Stags meets monthly. Anyone desiring to be on the announcement list for future meetings should contact Mike Smaracko, at This e-mail address is being protected from spam bots, you need JavaScript enabled to view it or 678-522-9553.

 

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