BETH ISRAEL MEDICAL CENTER PERFORMS
ROBOTIC ASSISTED PROSTATE REMOVAL SURGERY

Beth Israel Medical Center was the first hospital in Manhattan to perform minimally invasive, robotic-assisted closed chest heart surgery using the da Vinci(TM)Surgical System, manufactured by Intuitive Surgical, Inc. In an effort to expand the use of the system into other clinical areas of excellence, the hospital is also the first in the New York Metropolitan area to use this same robotic surgical system to perform radical prostatectomies.

Beth Israel's Caner Dinlenc, M.D., Physician-In-Charge of Endourology and Joseph Wagner, M.D., Physician-in-Charge of Urologic Oncology, are working as a team in performing robotic assisted prostatectomies, and have already done several cases.

"The development of the da Vinci(TM) Surgical System resulted from a push by the U.S. Army for technology that would allow surgeons to operate immediately on soldiers wounded in the battlefield," says Dr. Dinlenc. "However, the use of this system has become more widespread over the past several years and we are excited to be using this state-of-the-art technology at Beth Israel for radical prostate removal surgery. The technique for this kind of surgery is built upon a platform of the same skills used to perform radical prostatectomy, laparoscopically. The primary benefits of the robotic technique will include significantly less blood loss, decreased postoperative pain, and shorter hospitalization."

How It Works
The da Vinci(TM)Surgical System consists of two primary components: the surgeon's viewing and control console and the surgical arm units that position and maneuver detachable surgical EndoWrist instruments. These pencil-sized instruments (with tiny, computer-enhanced mechanical wrists) are designed to provide the dexterity of the surgeon's forearm and wrist at the operative site through entry ports of less than 1 cm. This enables the surgeon to enter the abdomen through keyhole incisions and perform prostatectomies. No major incision is necessary.

One port allows access for the endoscope, a tiny camera that is attached to a fiber-optic cable. The other two ports provide access for surgical tools. Instead of the surgeon holding the tools, the robot's wrists do -- bending back and forth, side to side, and rotating in a full circle -- thereby providing greater range of motion than humanly possible.
The wrists of the robot mimic the motions made by the physician, who sits at a console outside the operating room. The surgeon peers through an eyepiece that provides high-definition, full-color, magnified, 3-D images of the surgical site provided by the endoscope. The physician moves his hands, which are attached to manipulation controls -- and the robot follows along.

"What is most intriguing about the da Vinci(TM)Surgical System , is that it has the potential to allow physicians to do procedures from remote locations," says Dr. Wagner. "Most importantly, this new robotic technology results in significantly less post-operative pain and faster recovery time. Instead of weeks, recovery time can be reduced to days. It is feasible for patients who have received radical prostatectomies to be back at work within two weeks following the procedure."

For more information about this procedure, please call Beth Israel's Urology Department at 212/844-8900.