Single-port robotic surgery for prostate cancer

One in nine men in the U.S. will be diagnosed with prostate cancer at some point during his lifetime. Now, doctors have a new tool for a smoother surgery and a quicker recovery.

It was no surprise to Bob Agee when he was diagnosed with prostate cancer.

"My dad comes from a large family," he said. "Seven kids, six boys, my dad being the eldest, and it was like checking them off a list. Each and every one of them had prostate cancer."

Agee's brother has it too.

Dr. Jeffrey Nix from the University Of Alabama at Birmingham believes Agee would be a perfect candidate for a new type of robotic system using a single port for surgery to treat his prostate cancer.

"So for prostate cancer surgery for example, you might have five or six different keyhole incisions," Nix said.

With the single port, the surgeon makes only one incision in the abdomen to enter and deploy the surgical instruments. This type of surgery can leave minimal or no scarring. Also, patients have a quicker recovery time.

"With a traditional multiport approach, patients will stay one night in the hospital, usually go home around mid-morning to lunch the next day," Nix said.

Currently, Nix is able to send the patients home the same day after the single-port surgery.

"So that they can get back to their normal quality of life faster," he said.

Agee and his brother were the first two patients at UAB to get this procedure done, and they were done on the same day.

The Food and Drug Administration approved the single port for urological surgeries at the end of 2018, and only 15 centers around the U.S. are currently using the system.

MEDICAL BREAKTHROUGHS

RESEARCH SUMMARY

TOPIC: SINGLE PORT ROBOTIC SURGERY FOR PROSTATE CANCER

REPORT: MB #4595

BACKGROUND: Other than skin cancer, prostate cancer is the most common cancer in American men. The American Cancer Society's estimates for prostate cancer in the United States for 2019 are about 174,650 new cases of prostate cancer and about 31,620 deaths from prostate cancer. Prostate cancer develops mainly in older men and in African-American men. About 6 cases in 10 are diagnosed in men aged 65 or older, and it is rare before age 40. The average age at the time of diagnosis is about 66. Prostate cancer can be a serious disease, but most men diagnosed with prostate cancer do not die from it. In fact, more than 2.9 million men in the United States who have been diagnosed with prostate cancer at some point are still alive today. (Source: https://www.cancer.org/cancer/prostate-cancer/about/key-statistics.html)

TREATMENT: Surgery is a common choice to try to cure prostate cancer if it is not thought to have spread outside the prostate gland. The main type of surgery for prostate cancer is a radical prostatectomy. In this operation, the surgeon removes the entire prostate gland plus some of the tissue around it, including the seminal vesicles. A radical prostatectomy can be done in different ways. The major possible side effects of radical prostatectomy are urinary incontinence (being unable to control urine) and erectile dysfunction (impotence; problems getting or keeping erections). (Source: https://www.cancer.org/cancer/prostate-cancer/treating/surgery.html)

NEW TECHNOLOGY: The University of Alabama at Birmingham has become one of the only 15 medical sites in the country with the new da Vinci SP Single Port Surgical System by Intuitive Surgical. Jeffrey Nix, MD, FACS, Director of Robotic Surgery at the University of Alabama at Birmingham said, "We're trying to continue to push the frontier of what we can do minimally invasively. It becomes less about the number of incisions and more about what's the end goal. Can we do surgeries that we couldn't do before minimally. For example, can we carry this off label? Can we use these skills in this minimally invasive approach to do things we couldn't do before? Can we do the same operation that we would do open and do it with less morbidity for the patients? And one of the factors that is constantly looked at here is length of stay in the hospital." (Source: Jeffrey Nix, MD, FACS)