Joel A. Rosenfeld, M.D.

• 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.

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