Da Vinci surgery

In prostate cancer, cancerous cells develop in the prostate. It is the most common cancer in men after skin cancer, and results in more deaths than any cancer except lung cancer. Possible treatments and prognoses for prostate cancer depend on the stage of the cancer, the Gleason Score5 and the age and general health of the patient. Thanks to the high level of awareness of the population, cancer is often diagnosed early, resulting in fewer deaths. Besides this, cancer patients can live an active, productive life after cancer treatment, thanks to new advances in medical technology at German cancer centers and clinics such as da Vinci surgery method.

Possible treatments

Apart from the da Vinci robot method, there are five well-known prostate cancer surgery types:

• Removal of the cancerous prostate (radical prostatectomy)
• Radiation therapy of the cancerous prostate, either by external radiation or radiation with radioactive seed implants (radiation therapy or brachytherapy)
• Cold cure treatment of the cancerous prostate (cryotherapy)
• Hormone therapy - not curative, but used in conjunction with radiation therapy or cryotherapy
• Observation (watchful waiting)

At our clinic in Germany, da Vinci prostate surgery is the first choice of treatment in the case of localised prostate cancer. Thanks to the ground-breaking surgical technique offered by da Vinci robotic surgery, many German surgeons now prefer da Vinci prostate surgery.

The new da Vinci surgical system supports the surgeons during laparoscopic surgery (keyhole surgery), which enables precise, minimally invasive removal of the cancerous prostate. Instead of a long cut in the abdomen, minimally invasive procedures such as da Vinci robotic surgery require five or six small cuts of 5–12mm, through which the surgical instruments and a high-performance surgical camera are inserted.

The da Vinci® Si HD Surgical System has two components:

1. the multi-arm surgical robot
2. the control console

The da Vinci surgical robot is positioned directly beside the patient during surgery. It is fitted with cameras and 2-3 robotic instrument arms. Implementing the movements of the skilled German surgeons at the da Vinci control console, these arms perform the surgery on the patient, with tremor-free precision.

During surgery, the da Vinci control console is operated by the surgeon who controls the precise da Vinci micro-surgical instruments, which are more dextrous than human hands. The movements of the surgeon are echoed 1:1 by the da Vinci® System. Instruments with 7 degrees of freedom implement these movements on the patient.

Endoscopic cameras provide 3D, 12x zoomed images of the surgical area.

Da Vinci Surgery - Advantages for the patient:

• Minimally invasive surgery (keyhole surgery)
• Less blood-loss
• Less pain
• No wound healing problems
• Excellent cosmetic results
• Faster recovery
• Shorter hospitalisation after surgery
• Retention of continence after urological surgery
• Retention of erectile function after urological surgery

An additional concern for prostate cancer patients is the retention of urinary continence and sexual functioning after surgery. Studies show that da Vinci surgery patients regain continence sooner and have less pronounced pain in the urinary tract than patients who have radiation therapy (brachytherapy) or other forms of treatment. Several studies also show that patients who are potent before surgery regain their sexual functioning (i.e. erectile function for sexual intercourse) within a year of surgery with the da Vinci System. Speak to your surgeon about realistic expectations regarding regaining your sexual function and a rehabilitation programme, including physical activity and medicamentous treatment after surgery.

Please note: The da Vinci Surgical System is not controlled by a robot. Highly proficient German surgeons always have full control of the procedure and the robot-supported da Vinci System platform is only there to assist him.

Da Vinci Surgery - Advantages for the physician:

• Three-dimensional depiction of the surgical area
• Improved recognition of details due to 12 times zoom
• Three-dimensional manoeuvrability of the instruments
• Higher degree of precision due to micro-instruments
• Balancing out of small irregularities in the surgeon’s movements (tremor-free surgery)

The da Vinci specialists at the Friedrichshafen Clinic

The specially trained da Vinci®-System surgical team consists of the head physicians of the Clinic for Urology, Paediatric Urology and Onco-urology, Dr. med. Wilhelm Esser-Bartels, Dr. med. Claus Friedrich Fieseler und Dr. med. Eberhard Köhler.

This team of experts has performed many laparoscopic procedures successfully. The da Vinci surgical method has been available at the Friedrichshafen Clinic since early 2011.

Da Vinci surgery is suitable for all patients with localised prostate cancer for whom laparoscopic or classical surgery is possible.

Do you have any questions about da Vinci robotic surgery?

In the case of any interest or questions regarding da Vinci® techniques, please contact one of our specialists or arrange an appointment and get all the information you need during our special da Vinci® consultation hours.