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Open vs. Robotic

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Posted 7/25/2015 1:03 AM (GMT -5)
Any difference in ED, Incontinence, cancer control?

My sister called yesterday from Baltimore. Her husband will be having SRT there till mid September.

Partin does mostly opens. (Ive already decided I don't wanna have robotics at JH).

He can do it while they're there. But it would be an open. (Her husband had one and came thru it with flying colors).

I'd have family to hold my hand with the added benefit of someone there who just went thru the same thing with the same doc.

Ed and incontinence. Much if any difference?

Thanks
Dave


Btw...I'm getting fairly used to having cancer (as much as one can, I guess) But...This is would be a really good opportunity to get it behind me.
Posted 7/25/2015 2:01 AM (GMT -5)
No difference - especially none in the hands of someone like Partin. One of the best.
Posted 7/25/2015 4:52 AM (GMT -5)
From a SE perspective, in today there appears to be no difference. Physically, you'll have one long incision vs. 4-6 small ones. The key, again, is how experienced is the surgeon?
Posted 7/25/2015 6:59 AM (GMT -5)
I can only say that I've had the robotic and I am very pleased with the result. No ED or incontinence and the recovery time was quite quick.

I tend to think robotic would have to be better when done by an experienced and skilled surgeon and the lack of difference in the stats is perhaps due to the number of surgeons who are new to the technology. It seems to only stand to reason that the precision would be better when the surgeon can magnify the image several times and set the scalpel to move at a fraction of his hand movement.

Recovery time may be an issue if your sister's husband does not have enough paid leave as I've heard it is at least 1 or 2 weeks less.

All that being said, if perhaps a week or so longer recovery time is not a major issue one will probably do well with an "open" performed by a very skilled surgeon.
Posted 7/25/2015 9:58 AM (GMT -5)
@TA....Partin was a protégé of Walsh. He's also a surgeon first and statistician second. As far as opens go...i believe JH, with him at the helm, is still the "go to" place for an open. They (JH...being somewhat on the cutting edge of nerve sparring opens) lost ground to other surgeons in the Da Vinci department.

@halbert...The scar doesn't bother me so much. (Ive seen Gary's, it's a real conversation piece!) I agree it's all all about the skill of the surgeon.

@Dreamerboy...My sister's husband has to be there for the next 7 weeks anyway for radiation treatments. This is why my sister called and said "Come on up and get yours done bro!"


Another benefit is JH is really a special place. They're the #3 hospital in the nation for a reason.

There was a time when my sister and her husband were my closest friends. I talked them into us sailing the Caribbean together years back. We had alot of fun.

The stars may be comming into alignment. Maybe everything really does happen for a reason...

Post Edited (island time) : 7/25/2015 9:08:58 AM (GMT-6)

Posted 7/25/2015 2:09 PM (GMT -5)
Island Time, with your stats I don't think there is an advantage to either surgical option as long as you choose a real expert like Partin to do the work. However, I guess if I was you and going to JHU, I would probably be seeing Dr. Ballantine Carter and enrolling in his AS program. It's a little hard for me to phantom why you are choosing the most invasive option to handle your issues. Of course, maybe there is more that I don't know/can't see so obviously you have to do what you feel is best for you. I haven't gone back and read your past threads/posts but I assume you have discussed your case with SBRT, LDR Brachy and HDR Brachy experts since those options are also likely to cure you but with a smaller chance of onerous side effects....

Jim
Posted 7/25/2015 3:09 PM (GMT -5)
It's the surgeon that matters, not the method. If you've got somebody with Partin's reputation, I think you sign on and let him do it any way he wants.

All things being equal with excellent surgeons, open surgery might require a few more days of recovery. A year from now you won't care that it took a few more days to recover.

My two cents' worth. Good luck with your treatment.
Posted 7/27/2015 11:09 AM (GMT -5)
I believe it's all about the practitioner. I had open RP at JH done by Ted Schaeffer due to Gleason 9. No complications. Nerves spared, but bad pathology (see below). I had ED pre op due to BPH treatments and it's total now after IMRT following failed RP. I'll be trying Trimix soon.

Bob
Posted 7/31/2015 4:11 PM (GMT -5)
IT, I AGREE with those who say it's about the skill of the surgeon, more than which procedure it is.
I'm thinking the only downside is a slightly longer recovery time, but in the big picture, that's not meaningful.
I also agree with you, knowing your situation, and the issues you have with it being done away from family, that this could be a great opportunity to get it done and behind you,

@Jim/Tudpock - from all of ITs posts here, I'm guessing he's thinking that he is not mentally cut out for AS in the longer term. Just my guess, as he has been doing AS effectively, up till now.
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