Robotic Prostate Surgery

Superior Prostate Cancer Treatment

Dr. Samadi performs robotic prostate cancer surgery using the da Vinci robotic system. This minimally invasive procedure employs the latest advancements in robotics and computer technology to completely remove the cancerous prostate.

During surgery, Dr. Samadi is in complete control of the robotic instruments at all times. His expert hands, translated into the EndoWrists, control every movement of the robot while the 3D view gives him a high definition magnification of the surgical field.

Absolutely not! It is critical for patients to understand that the robot alone does not ensure success. Dr. Samadi controls the surgery from start-to-finish, expertly directing every movement of the robot based on his vast experience. Further, patients need not worry about technical issues during surgery as Dr. Samadi has the breadth of experience to expertly continue the surgery to successful conclusion, with or without the robot.

Since robotic prostate surgery uses tiny incisions, there is very little blood loss to obscure the surgical field. That clarity, plus the 3D magnification, provides superior visualization of the prostate. The dexterity and size of the robotic instruments enable Dr. Samadi to operate on the walnut-size prostate, densely surrounded by nerve bundles.

Another critical benefit of surgery is prostate cancer staging. While this may seem backward, the truth is that current prostate cancer diagnostics are somewhat limited in their ability to precisely stage the disease. Research shows that in as many as 40% of prostate cancer cases, post-surgery tumor analysis revealed a more advanced disease than shown by pre-surgery testing.

Robotic prostate surgery is the only prostate cancer treatment that definitely removes the cancerous prostate and gives men the lifelong assurance of a nearly undetectable PSA level.

There are several factors to consider in choosing your robotic prostate surgeon. The most important thing to remember is that technology does not drive outcomes; the robot is only as skilled as the surgeon. As these questions:

  • How many successful robotic prostate surgeries have you performed?
  • Do you perform the entire surgery? Will I be your only patient in surgery at one time?
  • What can I expect after surgery? What complications do your patients usually experience?

Dr. Samadi has unparalleled experience in robotic prostate removal surgery. He has successfully removed over 5,600 cancerous prostates with his novel SMART Surgery for robotic prostate removal. He conducts every surgery himself from start to finish. Preservation of sexual function, urinary control, and quality of life after prostate cancer are his top priorities.

SMART Surgery

Many patients are able to return to work and regular activity in just 2-3 weeks after Dr. Samadi’s SMART prostate cancer treatment. Within 4-6 weeks the majority of patients feel comfortable resuming most activities.

The Samadi Modified Advanced Robotic Technique (SMART) Surgery is an innovative, robotic-assisted laparoscopic prostatectomy (RALP) technique. It was expressly designed to spare the neurovascular bundles responsible for erectile function and better manage the urethra for optimal continence after surgery.

To further enhance the minimally invasive nature of the procedure, Dr. Samadi approaches the prostate from the inside out, rather than the outside in. During surgery he preserves the three delicate areas most important to sexual function and urinary control:  the urinary sphincter, the endo pelvic fascia, and the neurovascular bundles. Urinary control is further preserved by leaving the dorsal vein complex unstitched until the close of surgery, allowing Dr. Samadi to control urethra length and reduce urinary leaking. He uses only cold scissors and clips during surgery, never cautery, to further protect nerves.

SMART Surgery in Dr. Samadi’s hands takes less than 90 minutes, and since the procedure is minimally invasive men typically return home less than 24 hours after the procedure. No blood transfusions are needed and recovery is much faster than with traditional surgery.

Dr. Samadi’s patients experience superior prostate cancer recovery results with a 97% prostate cancer cure rate. After robotic prostate surgery a man’s PSA should be nearly undetectable; that zero PSA provides a lifetime of cancer-free assurance. After SMART Surgery, 96% of Dr. Samadi’s patients regain urinary control in just 2-3 months and 85% regain sexual potency in 12-24 months.

One of the benefits of robotic prostate surgery is that the catheter is removed just seven days after the procedure – that’s 1-2 weeks faster than with open prostate removal patients. Dr. Samadi will remove your catheter during an in-office follow-up procedure using x-ray to ensure proper urethra-bladder connection and healing.

Sex After Prostate Cancer

The resumption of sexual function after prostate surgery can take time. Erectile dysfunction (ED) symptoms just after prostate removal are a normal part of recovery and are not an indication of permanent change. Most of Dr. Samadi’s patients are able to enjoy normal sex lives with complete erectile function in 12 to 24 months. Younger patients may experience faster or improved results.

Dr. Samadi’s unique SMART Surgery delivers improved recovery results and helps patients return to an enjoyable sex life after prostate removal. His preservation of the endo pelvic fascia and neurovascular bundles, as well as the elimination of cautery, all work to reduce nerve damage and speed sexual performance recovery.

You will still be able to achieve and enjoy orgasm after robotic prostate surgery. Since the prostate is responsible for producing ejaculate, ejaculation will cease once the prostate is removed.

During your recovery it is important to celebrate your victories. You are cancer-free! Take time to enjoy intimacy with your partner and reestablish your physical and emotional connection. There are several treatment options to assist you during recovery or to address ED that continues beyond 24 months. Dr. Samadi is dedicated to helping his patients through this process and will work with men and their partners to find the right solution for sexual wellbeing after prostate cancer surgery.

The easiest first step is to try oral medications for assistance achieving and maintaining an erection. These include prescriptions such as Viagra® (sildenafil citrate), Levitra® (vardenafil), and Cialis® (tadalafil). Most patients experience very positive results with these ED drugs and using them can help rehabilitate your penis and erections.

If ED medication is not immediately successful, don’t be discouraged. Sexual activity and “exercising” the penis is an important part of sexual recovery. Research shows that erections can enhance oxygenation of tissue and suppress scarring. It could take time for your nerves to regenerate and recover enough to respond to medication assistance. In the meantime, penile injection therapy is a very reliable and effective option for achieving an erection. Injection therapy may also improve your return to normal function.

In a small number of patients, erectile function may not return after radical prostate removal. These men are encouraged to explore highly successful penile implant surgery. A penile implant provides a permanent solution to ED and delivers a very high satisfaction rate for patients and their partners. If needed, Dr. Samadi will refer patients with advanced ED to a specialist with expertise in penile implant surgery.

Continence After Prostate Cancer

Urinary incontinence after robotic prostate removal surgery is almost always short term. The impaired urinary control that most men experience after prostate surgery is very similar to the stress incontinence that women have after childbirth. The sphincter muscles that manage the release of urine may be temporarily disrupted or damaged during surgery.

Dr. Samadi’s unique SMART Surgery methods allow him to avoid the urinary sphincter during surgery and significantly improve urinary outcomes. Additionally, by leaving the dorsal vein complex stitch until the end of surgery he is in complete control of the length of the urethra, thereby reducing leaking after surgery.

The good news is that 97% of Dr. Samadi’s patients regain urinary control in just 2-3 months. Most often, the short-term incontinence that men experience after prostate cancer surgery involves slight dripping or leaking, particularly during strenuous activity. Sometimes even a cough, sneeze, or laugh can trigger unwanted bladder emptying.

Dr. Samadi recommends kegel exercises to every man after robotic prostate surgery. This simple exercise involves repetitive sets of clenching and releasing the muscles that stops the flow of urine. Research indicates that men who begin these exercises prior to surgery see improved recovery results afterwards.

Some patients may be advised to take prescription medications such as anticholinergics to alleviate the frequent sensation of having to urinate. For some, decongestants can help strengthen sphincter muscles, but should only be used under physician advisement. Collagen injections can also be used for short-term relief from issues of incontinence after prostate cancer. Urine control is improved by plumping the urinary sphincter through a series of collagen injections.

Long-term incontinence after prostate removal is rare. Dr. Samadi and his team of specialists at Lenox Hill Hospital will assist men with long-lasting incontinence through a range of treatment options. Several surgeries are available for restoring urinary control in patients whose symptoms persist for a year or more.