University of Rochester Surgeon Demonstrates Robotic Prostate Procedure

Horseheads Man’s Surgery to be Viewed by Urologists at Major Conference in San Francisco

May 24, 2010

Surgeon Jean Joseph, M.D., at the upper right, uses the daVinci Surgical System to remove the cancerous prostate of a patient at the University of Rochester Medical Center. He is among the top robotic surgeons in the country.

One of the nation’s top robotic surgeons will remove the cancerous prostate of a Horseheads man during a live demonstration of robotic surgery on Saturday, May 29. University of Rochester Medical Center surgeon Jean Joseph, M.D., will showcase the high-tech procedure, because of his expertise, during the American Urological Association conference in San Francisco.

Joseph will demonstrate via satellite one of the most advanced surgical procedures to treat prostate cancer, a robotic radical prostatectomy. He is head of the section of laparoscopic and robotic urologic surgery at the Medical Center and James P. Wilmot Cancer Center.

Joseph is one of the most experienced surgeons in the field having performed about 2,000 robotic surgeries. He is one of just two robotic surgeons selected to perform a live demonstration during the conference, where thousands of physicians from around world gather to study and advance urological care.

Gordon Shafer, 46, is unfazed by having hundreds of specialists watching his life-saving cancer surgery. He was diagnosed with prostate cancer in April, by his urologist Robert Douenias, M.D. His physician, Aleksander J. Rupik, M.D., recommended close monitoring by the urologist.

Douenias had been closely watching Shafer’s prostate-specific antigen level, which can be an indicator of prostate cancer. Successive tests showed the PSA level tripled in a year, which led to a prostate biopsy showing the cancer.

“Dr. Douenias found the cancer and immediately sent me to see Dr. Joseph to consider the robotic surgery,” said Shafer, a car-buying specialist with Corning Federal Credit Union. “I know I’m in good hands with Dr. Joseph.”

Douenias will participate in the live telecast as a moderator, presenting Shafer’s medical history and discuss prostate cancer surgery. There will be moderators here in Rochester and in San Francisco to interact with the conference attendees, discussing the surgical techniques performed by the Rochester team. Joseph and the experienced team of surgeons, anesthesiologists, and nurses will focus on delivering the best surgical care to treat Shafer’s condition.

The prostate is a walnut-sized gland in the male reproductive system located just below the bladder and in front of the rectum. The prostate contains cells that make seminal fluid, which nourishes and protects sperm. Each year, more than 230,000 men are diagnosed with prostate cancer and 30,000 men die from the disease. Although prostate cancer is the second leading cause of cancer-related death among American men, it is nearly always curable if it’s caught early.

Removal of the prostate using the robotic technology can be done in a short amount of time in experienced hands with excellent results. Most men are able to return home in a day. The procedure results in minimal blood loss and easier recoveries than traditional open surgery. As in any discipline, experience matters, Joseph said.

Leaders in Robotic Surgery

The volume of robotic surgeries has risen dramatically in the past decade, as demand for the minimally invasive approach grows and surgeons grow more comfortable with the technology. 

Joseph and surgeons at Strong Memorial Hospital were first in the region to introduce the daVinci Surgical System in 2003. Now, Joseph performs as many as 12 robotic surgeries per week at Strong Memorial Hospital. He is part of a team of surgeons who are expanding the use of surgical robots. The Medical Center remains the most experienced in the region, having performed nearly 4,000 procedures for urologic and gynecologic conditions. 

The Medical Center has four robots which is the most of any center in upstate New York. There are two robotic systems at Strong Memorial Hospital, and one at Highland Hospital, which are used for patient care, and the fourth robotic system is for education and research in novel techniques by the medical center faculty.

The education and research is provided by the URMC Center for Robotic Surgery and innovation to expand the use of robotic technology and to continue to improve patient care. The center provides hands-on education for doctors who want to specialize in robot-assisted surgeries and use techniques honed by our surgeons.

“As the medical community embraces robotic-assisted surgery, our researchers, nurses, and surgeons will continue to lead this field,” said Joseph, head of the section of laparoscopic and robotic urologic surgery.

“This will offer our patients significant benefits because the quality and experience of our surgeons will surpass all others. We have been at the forefront of this field,” Joseph said.

During robot-assisted surgery using the daVinci Surgical System, patients are positioned as they would be during most surgical procedures, with medical personnel surrounding them, yet a surgeon is located at a console a few feet away.

Supporting surgical team members install the correct instruments at the surgeon’s request. The instruments are designed with seven degrees of motion that mimic the dexterity of the human wrist. Each instrument has a specific surgical mission such as clamping, suturing and tissue manipulation.

Although the surgeon is not physically in contact with the patient, the daVinci control console allows the surgeon to actually see the surgical field in enhanced detail as a result of the three-dimensional image transmitted from the laparoscopic cameras. The surgeon manipulates the robotic “hands” in real-time using master controls, seeing minute, 3-D details inside the patient with the aid of the cameras located inside the patient. The surgeon’s fine motions are replicated inside the patient with great dexterity.

When using the robot, Joseph said it’s like “being inside the patient. The 3-dimensional view provides greater depth perception and brings us closer to the surgical site, which helps improve accuracy and precision. It is a great use of technology to enhance surgical care. With experience surgeons are able to deliver superb care to their patients.”

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