An explanation of nerve saving

This may help explains what goes on and shows the difficulty of the procedure:

vimeo.com/6599375

Bill

That`s all way beyond my IQ. The surgeons deserve respect.

All the best from England.

Bill

Thanks for a great link.

Holy Carp.

Here's a thought. I am under the impression that nerve fibers have small voltages going through them as they send and receive signals. Imagine there was a probe sensitive enough to detect these small impulses. The Agilent 34420A Nanovolt meter is down in that level.
This can be attached to the cutting edge of the tool. If current is detected, a tone would sound to warn the surgeon. I understand sometimes the nerves have to be cut but I can easily see how sometimes they can be cut just because they are mixed in with the rest of the tissue and are not discernible from the mass.

This looks like a worthwhile study. If someone wants to go for the grant, I'll participate by supplying the electronics. At the very least we can characterize the current flow.

Jeff

I did more research.
"Each nerve fiber in a nerve is capable of generating an action potential which can be propagated along its length without any loss of amplitude or velocity..." Imagine a low level AC electrical signal, 40 kHz at 1.0 mV, is injected continuously into the prostate. The nerves would conduct this signal better than the surrounding tissue. The DaVinci front end would have a filter tuned to the sending signal. This can be sensed inductively or by direct contact. If the tool detects the sending signal it sets a warning tone.

Post Edited (Worried Guy) : 8/2/2010 9:50:19 AM (GMT-6)

An interesting post, and a heart stopping video. I think I'm glad I watched this after surgery, not before!

As for Jeff's idea --- best I understand it --- of going at my prostate with an electrically charged knife, a al "the chair" at Sing Sing I'm really glad I'm not the guinea pig on that one! However, once Jeff has perfected this device (and he should charge a royalty based on use, not sell the technology) I'll be quite happy to take a cut of the winnings.

Sheldon AKA Sleepless

This reminds me of the comment from Dr Dwight Harken (the U.S. Army doctor from WWII who pioneered open heart surgery).

When describing his heart surgery research in an interview he said:

All of his first 14 subjects died.
Of the second group of 14, half died.
Of the third group of 14, only 2 died.
Of the fourth group all survived.
The first 3 groups all of the subjects were lab animals ... (dogs).
The last group were all human patients.

Practice, practice, practice .. but not on me!

(Do urologists count lab animals among their 'surgeries total count' ? ;-)

Jim

It's still pretty hard for me to equate open and robotic. I just can't imagine the surgeon being able to do as well without the robotic advantages.

Could be however, that accidents happen when he meant to go left but told the robot to go right. Kind of like when I rent an excavator. Peiodically I will move the lever the wrong way. Doesn't hurt the dirt very much, but glad I'm not around microscopic nerves.

I have seen a couple dozen RP and RALP procedures. I've started to understand what they are doing, but I have to say that you can see why the more experienced the doctor, the better the results. Tewari is very well known for his work with RALP. I saw one of these videos on Youtube before I chose a doctor. So I chose a guy with 1500 behind the belt...

Or is that under the belt?

Tony

Mine was removed and my nerves were spared. It was done perfectly and "Mr. Happy" is working very well. I searched for an experienced surgeon and thank God I found one. After getting the cancer removed, my greatest fear was having no more erections. Five days post op I woke up with my first beginning erection. A little over two years later I am just as pre op minus the semen. But everything else, erections, stimulation, orgasms etc are fantastic. If pc is found early and removed by an experienced surgeon the chances are good that you will be "back in the saddle agian".