If you are still considering what kind of treatment to have for prostate cancer and your urologist has you fast tracked to have robotic surgery using the Da Vinci system you need to read this.Almost 3 years ago we posted articles about how the radical prostatectomy is a blind operation and one even a surgeon would not have and preferred proton radiation. A Surgeon’s Story
We also posted an article by the Oct. 2007 Wall Street Journal (WSJ), about how the outcomes of prostate surgery completely depends on the skill and experience of the surgeons. You might think this is a “given” but so many men like myself look upon the doctor or surgeon with unwarranted respect and so we will be reticent to question his judgment and reluctant about getting an second opinion. Or we will compromise not seek the very best surgeon he can find in the United States. Over the past 3 years I’ve met and learned from men in our ProtonPals group who will travel extensively to the best centers in the U.S. to get a second opinion and eventually to get treated even if it means leaving home for a couple of months. See My Journey
Of course there are circumstances that will limit the choice you make, e.g. the time and expense of travelling out of town, the need for having family and friends around, and insurance coverage for the surgeon. However you should be very selective. Remember “Knowledge can be the best medicine of all”. So here’s a bit of knowledge.Some urologists in the NY State study performed 2 –3 surgeries a year while as an example a top urologist in Houston performs more than 250 a year. That means if he’s completing more than one operation a day, he could very well be going from suite to suite to handle multiple operations in a day as in done at Penn. The average prostate surgeon in New York State performs fewer than 4 operations a year. Original WSJ Article by Peter B. Bach October 27, 2007 You probably won’t get a good outcome out of the surgeon who only does a few a year.Now last week Larry Hock sent us this article from the Wall Street Journal and the same thing applies to highly technical robotic surgery, maybe even more so. Small regional centers with low surgery loads are adopting the Da Vinci robotic system. They may have for example a 100 cases a year for 4 –5 surgeons. In this WSJ story, a 178 bed non profit center in New Hampshire had the bad luck of making the news.
- Some small centers don’t perform enough surgeries
- Surgeons usually will not take the time off to get the requisite training.
- It can take 250 – 700 cases to master the use of the Da Vinci system.
- If used with inadequate training it can do more harm than good.
- In one example surgeons got only 2 days of hands on training on pigs and cadavers.
- Think of your child’s or grandchild’s X box game and see how difficult this is to control the elements in there. I can’t keep the cars on the track.
I’m not making a medical recommendation but giving you an encouragement to get more knowledge and use it to set your course.
