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da Vinci

Robot-assisted prostate cancer surgery with The da Vinci surgical system

In August 2012, Jyoban Hospital introduced a surgical support robot “da Vinci S (da Vinci Surgical System)” (Intuitive Surgical, USA) for the treatment of prostate cancer. The introduction of this robot has made it possible to perform more accurate prostate cancer surgery, and patients experience less physical burden and fewer complications. Surgery using the da Vinci system is performed under the complete guidance of Professor Kazunari Tanabe, Department of Urology at Tokyo Women’s Medical University, who is active on the frontline of prostate cancer treatment. With the introduction of the first da Vinci system in Fukushima Prefecture, people can now receive Japan’s most advanced prostate cancer treatment in Iwaki City.

What is prostate cancer?

In the recent years, the incidence of prostate cancer has been increasing, and it is one of the prostate diseases to watch out for in middle aged and elderly men. Male hormones are involved in the development of prostate cancer, and unlike cancers of other organs, it often progresses slowly. Prostate cancer can be screened by measuring PSA (prostate specific antigen) in the blood; this is one of the cancers for which blood tests are effective. As there are few subjective symptoms during the early stage, it may have spread to the bones after symptoms such as dysuria occur.
Early detection with PSA test and to receive an appropriate treatment are important.

About the da Vinci system

This is a surgery supported by a robot developed in the United States. By operating through the robot, it has the feature to enable more precise surgery with clear images. The da Vinci system comprises the following three parts: operation part known as a surgeon console, robot arm part known as a patient cart, and monitor part known as a vision cart. In prostate cancer surgery, six holes of 5–12 mm sizes are drilled in the abdomen, a 3D camera and robotic arm are inserted from there, and the surgeon sitting on the surgeon console performs the surgery while viewing the 3D image.

Features of the da Vinci system

3D high-definition image

Your surgeon can perform the surgery under the stereoscopic image. In addition, 720-p high-definition images show details of the tissue surface and important autopsy. Further, the digital zoom function allows your surgeon to see more detailed organ conditions.

Intuitive Motion and shake prevention function

The surgeon console links the movement of the surgeon’s finger with the instrument (forceps), and this provides intuitive motion.
In addition, it reduces the finger movement while removing minute camera shake, and thus it responds to small and complex movements.

Forceps with large range of motion

The EndoWrist instrument connected to the robot arm has the same or better range of motion as the human hands. As a result, complicated movements that are impossible with normal laparotomy or laparoscopic surgery are also possible, enabling more precise and accurate surgery.

Robot-assisted prostate cancer surgery with the da Vinci system

Conventional prostate cancer surgery is one of the difficult operations because the prostate is an organ behind the pelvis. In addition, a large vein running around the prostate gland is a problem, which might lead to large amount of bleeding if damaged. Furthermore, postoperative urinary incontinence and erectile dysfunction (ED) are also major issues.
Later, laparoscopic radical prostatectomy was introduced as a minimally invasive surgery for prostate cancer and has been performed at Jyoban Hospital. Compared to laparotomy, it causes smaller wounds and less bleeding. However, it has the disadvantage of taking a long time to master the operation.
Thus, robot-assisted prostate cancer surgery using the da Vinci system is a surgical procedure that can compensate for these shortcomings of conventional surgery. By operating the robotic forceps with a large range of motion having anti-shake mechanism while viewing the 3D image, it has become possible to perform surgery more safely, accurately, and with fewer complications. The amount of bleeding is 10–100 times lower than that of laparotomy, and erectile dysfunction can be prevented by preserving the erectile nerve more precisely with 3D magnified images. In the same way, for ureteroneocystostomy, the robotic forceps with a large range of motion bring the accurate anastomosis, thus reducing urinary incontinence. For the original purpose of surgery, which is to remove prostate cancer cells, it can be surely performed by accurately viewing the enlarged image of the organ.

Demonstration of precise movement using the da Vinci system (folding crane)

Inquiries about the da Vinci system

Jyoban Hospital provides consultations for those who wish to have "Robot-assisted prostate cancer surgery with the da Vinci System" at any time.
Doctor in charge: Hiroaki Sinmura
57, Kaminodai, Jobankamiyunagaya –machi, Iwaki City, Fukushima 972-8322
Jyoban Hospital, Public Interest Incorporated Foundation Tokiwakai
TEL : 0246-81-5522 FAX : 0246-81-5577
Email address: info@tokiwa.or.jp

Urology