“Robotic Surgery“ has revolutionized the medical field by storm. This surgery is gaining immense popularity for prostatectomy, hysterectomy, and heart related diseases. It is a minimally invasive surgery performed by a robot, wherein the systems are controlled by the surgeon and his/her movement’s are translated in the computer and further carried out by the robot on patients. Here, the robotic arms are attached to long instruments and are placed through small keyhole openings in the patient’s abdomen instead of the surgeon’s hands.
Though, the robot performs the operation but the entire process is actually controlled by the surgeon, which includes handling the forceps with the help of ‘master control’. The surgeon monitors the robot’s work and every movement step by step. Da Vinci Surgical System – state-of-the-art technology is used for this surgery.
Why is Robotic Surgery gaining popularity to cure prostate cancer?
Basically, prostate cancer is a malignant tumor forming in the small outer part of the masculine gland. It usually happens when the prostate cells grow without any control and invades nearby tissues to spread rapidly throughout the body. Usually if the disease is detected at an early stage it’s curable but if it’s not detected and treated on time then it can prove futile.
The reason why “robotic surgery for prostate cancer“ is gaining popularity is due to its high level of precision during operation compared to traditional surgeries. Robotic Prostatectomy removes the entire prostate, which involves taking out all the prostatic tissue and lymph nodes. After completion of the surgery the patient can go through Prostate-specific antigen (PSA), where the results for any disease will show negative as the cancer gets eliminated completely due to this low-dose radiation.
Besides there are numerous other potential benefits of Robotic Prostatectomy over traditional (open) prostate surgery, this includes:
- Small incisions
- Very low amount of blood loss
- Faster recovery
- Less expensive and shorter period of stay in hospital
- Minimal pain
- Less risk of infection & scarring
- Better erectile function
Moreover, the best part of this surgery is that the patient’s life won’t change very drastically due to it and they will be able to return back to their normal life as soon as possible. It’s indeed amazing that how this technology has expanded with leaps & bounds to completely eradicate certain urological diseases like prostate cancer.
Prostate cancer is a form of cancer that grows in the prostate, a gland in the male reproductive system. Prostate cancer is most common in the developed world with cumulative rates in the developing world and it is the sixth leading cause of cancer among men globally.
Based on the three factors such as TNM stage, PSA and Gleason score, the patients are classified into high, intermediate and low risk groups. The low risk patients are usually treated with radical prostatectomy or radiotherapy alone.
Patients who are classified in intermediate risk disease are usually treated with radiotherapy and a short duration (less than 6 months) of hormonal therapy. It depends upon surgeon’s decision to prefer for robotic radical prostatectomy or not. Although the role of surgery in these patients remain uncertain, and the patient with high risk disease are usually treated with radiotherapy and a long duration of hormonal ablation. Many high risk patients are not cured by this treatment.
Stages of Prostate Cancer Using TNM System:
Prostate cancer is staged using the TNM system. This is used all over the world. It separately assesses the tumor (T), lymph nodes (N) and secondary cancer (metastases – M).
- T – For tumor — describes the size of the main area of prostate cancer.
- N – For nodes — describes whether cancer has spread to any lymph nodes and to what extent.
- M – For metastasis — means distant spread of prostate, for example, to the bones or liver.
Different Stages of Prostate Cancer:
There are four Stages of Prostate Cancer that we have discussed it below. Following are the different Stages along with their treatments.
In stage I, cancer is found in the prostate only. The cancer is found by needle biopsy or in a small amount of tissue during surgery for other reasons (such as benign prostatic hyperplasia). The PSA level is lower than 10 and the Gleason score is 6 or lower. It is found in one-half or less of one lobe of the prostate. It cannot be felt during a digital rectal exam and is not visible by imaging. They usually grows very slowly and do not show any symptoms at the early stage. The cancer is very small and completely inside the prostate gland, which feels normal during a rectal examination.
- Surgery to remove the prostate gland (called radical prostatectomy). Since it is too small, surgery is not preferred at this stage.
- Watchful Waiting or Active Surveillance. In this therapy, the doctors closely watch the tumor to see if it causes any symptoms or it appears to be growing. Common test such as PSA is usually done in this method.
- Radiation Therapy: It uses high frequency x-ray beam to kill prostate cancer cells or to refrain them from being divided and grow rapidly.
In stage II, cancer is more advanced than in stage I, but has not spread outside the prostate. If it is not treated then it is likely to spread outside of prostate. If the patient is so elder or having more complex diseases or after watchful waiting there are no any significant increase in growth of cancer tumor, then in such cases
Radical Prostatectomy and Radiation Therapy are the preferred options. Stage II is divided into stage IIA and stage IIB.
In stage IIA, cancer:
The PSA level is lower than 20 but higher than 10 and the Gleason score is 6-7. It is found by needle biopsy or in a small amount of tissue during surgery for other reasons.
In stage IIB, cancer:
Such cancer is found in opposite sides of the prostate. The PSA can be any level and the Gleason score can range from 2 to 10. In some cases, the tumor has not spread outside the prostate and such tumors cannot be felt during a digital rectal exam and not visible by imaging. In such cases, the PSA level is 20 or higher and the Gleason score can range from 2 to 10.
- Radiation therapy with ADT
- Hormone Therapy: It is used to stop the production of testosterone and all androgens either temporarily or permanently. Prostate cancer grows when it is exposed in presence of testosterone, so this therapy is used to stop its production.
- Radical prostatectomy and sometimes proceeded by hormonal therapy. In some cases the lymph nodes are removed.
- Brachytherapy and external beam radiation combine. The radiation theraphy also includes follow up of hormone therapy.
In this stage, the cancerous cell has significant growth. Cancer tumor has spread beyond the prostate gland but not has reached to bladder, lymph nodes, rectum or any other organs. Some times for elders doctors prefer to go for watchful waiting stage. This is preferred only if patient is having many sever complications or other illness.
The PSA can be any level and the Gleason score can range from 2 to 10.
- External beam radiation plus hormone therapy
- Radical prostatectomy in selected cases. Many times pelvic lymph nodes are also removed. Radiation therapy may be followed after this surgery.
- In some cased only hormone therapy is preferred.
This is the final stage of the cancer and usually it is not curable. It has grown into the bladder or rectum, or has spread to the lymph nodes or another part of the body. It may spread to the bones, liver or lungs type of distant places. In this case, removing any part of the body will not solve the problem. It is preferred to wait and watch for the elder person.
- Hormone therapy
- External beam radiation plus hormone therapy (in selected cases)
- Surgery such as TURP which helps in reducing symptoms such as bleeding
- Some reliving treatments are also done to reduce symptoms such as bone pain.
We have discussed here different stages of prostate cancer along with their Prostate Cancer Treatment.
For more information you can visit our website: http://www.mpuh.org/centreforroboticsurgery/
For Prostate cancer treatment robotic surgery is a common choice to try to cure prostate cancer if it is not thought to have spread outside the gland (stage T1 or T2 cancers).
The main type of robotic surgery for prostate cancer is known as a radical prostatectomy surgery. 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.
A less invasive surgical option – Laparoscopy is available for urologic surgery that uses small incisions. But, due to some the limitations of laparoscopy procedures it is not suggested
for more complex urologic surgeries.
One of the most modern and effective way of surgery is robotic radical prostatectomy surgery. It is a minimally invasive approach, using the latest Da Vinci Robotic Surgical System and
it is ideal for delicate urological surgeries.
Advantages of Robotic Prostatectomy:-
Robotic Prostate Surgery:
Clinically Superior Results
Reduced Risk of Complications
less post operative pain
Less blood loss
A shorter hospital stay
Faster recovery and return to normal activities
Fater return of urinary continence
Dr. Mahesh desai is the head of robotic surgery for prostate, kidney and urinary bladder cancer at Muljibhai patel urological hospital ( Centre for Robotic Surgery) in India. He is Top Urologist in world. It is the first super specialty hospital in India dedicated to Urology. We serve our patients for more than 35 years and we are popularly known as “Nadiad Kidney Hospital in India”.
Radical Prostatectomy is the operation done to remove the prostate gland and nearby tissue in order to remove prostate cancer. Earlier, the prostatectomies were done using open surgeries, but with the modern advances in the field of surgery, laparoscopic surgeries (also known as minimally invasive surgeries or keyhole surgeries) have become the more preferred and common type. And even though there always are certain risks involved when it comes to surgery, for prostate cancer surgery turns out to be the most effective type of treatment as it removes malignant tumors without producing the painful side effects of radiation therapy or chemotherapy.
During the last decade, robot-assisted prostatectomy procedures have vastly outnumbered the open radical prostatectomy surgeries. In fact,according to a study conducted in 2013, robot-assisted prostatectomies accounted for around 85% of all radical prostatectomies (compared to just 22% in 2003).
Here are some of the main reasons why both surgeons and patients prefer robotic surgery for prostate cancer over the open surgeries.
Benefits of Robot Assisted Radical Prostatectomy
Some of the most notable advantages of robotic prostate cancer surgery include:
- Better Results
Robotic surgical systems like the da Vinci system (also used at Centre for Robotic Surgery), are known to provide better clinical results for prostate cancer surgery as compared to other traditional procedures. This is since such a robotic surgical system offers the surgeon with more degrees of freedom than a human hand and magnified 3-D image of the ongoing procedure, as well as enables the surgeon to make much more precise movements inside the incision than they ever could on their own.
As a result, the efficiency and ease of robotic radical prostatectomy is far higher compared to non-robotic surgeries, and it also reduces damage to the healthy tissue and scar tissue build up. Therefore, the overall clinical results are far superior in a robotic prostatectomy.
- Lesser Complications
While any prostatectomy is not completely safe, the risk of complications is much less in a robot-assisted radical prostatectomy than in other types. The development of infection at the incision site, which is a primary cause of delayed recovery, is more common with open surgeries compared to robotic.
The surgical systems such as the da Vinci surgical system requires only four to five incision which are smaller than two inches; while other traditional open surgeries require bigger, six-to-eight inch incisions instead. As a result, the chances of post-operative infections are much higher in non-robotic surgeries.
- Quicker Recovery
The use of robotic surgical systems has many benefits, chief of those being smaller incisions, less number of sutures, more effective removal of cancerous tissue, less damage to the healthy tissue, minimal bleeding, and reduced contact between the incision walls and the surgical instruments. All these benefits translate directly into a speedier and more hassle-free post prostatectomy recovery of the patient.
- Minimum Scarring
Apart from the obvious aesthetic benefit, minimum scarring caused by robotic surgeries also ensures better healing. This is because in certain rare cases, open surgeries can lead to excess scar-tissue build up, which can affect the normal functioning of the prostate.
And therefore, among the various prostate cancer treatment options, robotic radical prostatectomy has fast become a top choice for both doctors and patients. To learn more about prostate cancer, outcomes of robotic prostatectomy, post-operative care, etc., click here.
Muljibhai Patel Urological Hospital (MPUH) – Centre for Robotic Surgery (CRS), Nadiad has organized a major International Seminar ‘American Urological Association (AUA) Segura International Urolithiasis Course’ during 21-23 February 2013. This was for the first time that the AUA Segura Course has conducted outside the USA in India at Nadiad Kidney Hospital. More than 450 faculties and delegates from about 20 countries have participated in the most prestigious programme on stone disease. The Seminar was inaugurated on 21st Feb by the Chairman of MPUH – CRS, Shri Rohit J Patel in the presence of ‘who-is-who’ in the field of kidney stone management from abroad and India. Some of the popular names participated in the conference including Prof. Glenn Preminger, AUA Representative; Dr John Denstedt, Treasurer of Endourological Society; Dr. Luc Valiquette, President-elect of SIU, Dr Meyappan, President of Urological Society of India; Prof. Dr. Andreas J Gross; Dr. Michael Wong; Dr. Mahesh Desai, Medical Director of MPUH & President, World Endourological Society and Dr R B Sabnis, Chairman, Dept of Urology Hospital, MPUH – CRS.
MPUH – CRS is ‘complete’ in all respects, in the treatment of stone disease, has done close to 26,000 procedures for removal of kidney stones by many methods, e.g. ESWL, Flexible Ureteroscopy, PCNL, Micro-perc, etc. MPUH – CRS has published 165 peer reviewed/indexed technical papers. It is in credit of these high standards and expertise on stone disease that the AUA permitted the authorization to MPUH – CRS to organize the AUA Segura International Urolithiasis Course at Nadiad. Dr Segura was a pioneer in the stone disease, and was a Founder-Member of World Endourology Society. In 2004, MPUH – CRS had hosted the World Congress on Endourology (WCE) in Mumbai when Dr Segura was elected the President of World Endourology Society. Right now Dr Mahesh Desai, the Medical Director of MPUH – CRS is the President of the Endourology Society.
India has more stone cases as compare to any other country. With the improvement in technology and new techniques in management of stone diseases, patients will be the ultimate beneficiaries. We are looking at treatment modalities that can remove stones without surgery. For the last ten years, not a single open stone surgery has been done at MPUH – CRS. MPUH –CRS has proposed to set up a Centre for Research in stone disease. Dr. Jens Rassweiler and his daughter Dr Marie Claire from Germany demonstrated for the first time outside Germany, a new technique ‘iPad guided renal access’ for clearance of stones. This technique may however take some more time for perfection.
This type of Conference offers great chances for the young and upcoming Urologists to learn from professionals in the field and explain themselves of the up-to-date developments in the field of urology. During the conference, more than 20 surgical procedures had being telecast LIVE from the operation theatres to the Conference venue for the benefit of delegates. The participants asked many questions directly to the operating surgeons to clear their doubts. They also have facilities for hands-on training on simulators and models in the JPAC labs. Many world renowned medical equipment manufacturers had set up their stalls at the Conference venue. The Conference was a grand success.
Dr. Mahesh Desai – Medical Director and Managing Trustee of Muljibhai Patel Urological Hospital, Nadiad – awarded an “Honorary Membership of Urological Society of Australia and New Zealand” (USANZ) on 16th April, 2013. He was awarded this membership for a life time.
The Urological Society of Australia and New Zealand (USANZ) awarded him in recognition of his extensive experience and expertise in the management of stone disease and his appointments as a Visiting Professor at the Duke University, Stanford University, Cleveland Clinic, University of Vienna and Hamad Medical Corporation, Qatar. This award also recognizes his membership of the American Association of Genito-Urinary Surgeons and appointment to the Editorial Board of Journal of Endourology.
By Mr. Vinesh Antani – A Renowned Gujarati Author
Dr. Mahesh Desai, the Medical director of famous MPUH hospital – Nadiad, has explained me in details about the side effect of prostate removal, when he decided to go for an operation for my prostate cancer. The important thing for me was to know that a patient loses the control over urinate after the surgery, and that lasts for indefinite period – it can be for a few days, weeks or even for a few months. Once the prostate is removed, and if the muscles are not strong enough, patient will not be able to have control over urinate.
For the purpose, Dr. Mahesh Desai strongly recommended me to do exercise regularly. The physiotherapist – Dr. Vijay gave me enough training for all type of exercises. These exercises are very simple, but patients have to do them regularly – before and after the surgery. Dr. Vijay has repeatedly reminded this instruction and I started following it.
Dr. Mahesh Desai performed my surgery on 28th May, 2013. After the surgery, all the doctors were regularly following up with me and all of them – including Dr. Desai have strongly recommended to continue the exercise. The physiotherapist – Dr Vijay used to visit twice a day, and kept on guiding about the exercise. Even the nursing staff reminded the same. I was worried about urine leakage. I followed the advice of Dr. Mahesh Desai and his team about the exercise quite sincerely. At hospital, I had nothing to do that is why I kept on exercising throughout my stay.
The catheter was removed on the seventh day after my surgery. Now, the urine was supposed to come out naturally. I was at a point, for which I was afraid of the most, when I couldn’t control the urine. Luckily, after few hours urine started naturally. I was very worried about controlling urine and I was praying God to take me out of this situation as early as possible. As per the instruction and the guidance given by expert team of doctors, I continued my exercise regularly. After removal of the catheter urine was passing naturally. I could feel urge of the urination. I could stand up and reach to toilet. Gradually I could hold urine up to four hours then five hours and finally up to six hours!! I was amazed that there was no single incident of urine leakage during the entire day. I made doctors aware about it and they were happy as well. When Dr. Mahesh Desai came for a visit in evening, I informed him about it. He was very happy and he added that “this is the result of your regular exercise”. It’s been 15 days, when I am writing this, since the catheter is removed. I still do exercises regularly and follow doctor’s instruction very carefully. I am glad that there is no single incident of urine leakage till now.
Friends, I just want to tell you one thing. Like every patient wants the best doctors for their treatment, even doctors want their patients to follow all their instructions. My own experience of following doctor’s instructions, kept me away from shameful situation of urinary incontinence. Such things give big relief to the patient. So every patient should follow the doctors’ advice very strictly and do the exercise regularly.
Event Name: Andrology Training Workshop For PostGraduates
Date:26 March 2015 to 28 March 2015
Venue:Jayaramdas Patel Academic Center,
Muljibhai Patel Urological Hospital,
Nadiad, Gujarat, India.
Contact Details :
Dr. Pradeep Ganatra,
Mo: +91 9824387701, Email: firstname.lastname@example.org
For Registration Click Here: Training
World environment day is also known as the Environment Day, Eco Day or short form WED. It has been one of the great annual events for years which is being celebrated worldwide by the people aiming to protect the unique and life nurturing Nature on every 5th June.
World Environment Day History
World Environment Day (also called as WED) has been started celebrating as an annual event on every 5th of June since 1973 in order to raise the global awareness about the importance of the healthy and green environment in the human lives, to solve the environmental issues by implementing some positive environmental actions as well as to make aware common public worldwide that everyone is responsible for saving his environment and not only somebody, government or organizations working for it.
World environment day was first established to be celebrated every year by running some effective campaigns by the United Nations General Assembly and United Nations Environment Programme (UNEP) in the conference on Human Environment began from 5th to 16th of June at United Nations in 1972. It was first time celebrated in 1973 with the particular theme “Only one Earth”. Since 1974, the celebration campaign of the world environment day is hosted in different cities of the world.
It is a big annual celebration started by the United Nations General Assembly to engage millions of people from different countries across the globe as well as draw attention of political and health organizations to implement some effective actions.
Why World Environment Day is Celebrated
World environment day annual celebration campaign was started to address the huge environmental issues like wastage and losses of food, deforestation, increasing global warming and so many. Every year celebration is planned according to the particular theme and slogan of the year to bring effectiveness in the campaign all through the world.
It is celebrated to successfully get carbon neutrality, focusing on the forest management, reducing greenhouse effects, promoting bio-fuels production by planting on degraded lands, use of hydro-power to enhance electricity production, encourage common public to use solar water heaters, energy production through solar sources, developing new drainage systems, promoting coral reefs and mangroves restoration in order to get prevented from flooding and erosion including other ways of environmental preservation. Some of the objectives of the world environment day campaign are mentioned below:
- It is celebrated to make aware the common public about the environmental issues.
- Encourage common people from different society and communities to actively participate in the celebration as well as become an active agent in developing environmental safety measures.
- Let them know that community people are very essential to inhibit negative changes towards the environmental issues.
- Encourage people to make their nearby surroundings safe and clean to enjoy safer, cleaner and more prosperous future.