SMART Surgery for Prostate Cancer Treatment in New York, NY
The Samadi Modified Advanced Robotic Technique, known as SMART Surgery, is a minimally invasive robotic-assisted laparoscopic prostatectomy developed by Dr. David B. Samadi after fellowship training in urologic oncology and laparoscopy and years of robotic surgery experience. At Prostate Cancer 911, SMART Surgery offers men with localized prostate cancer an advanced option designed to remove the cancer completely while giving them the best possible chance of maintaining sexual function and urinary control.
What Makes SMART Surgery Unique?
Dr. Samadi performs every SMART Surgery himself, from start to finish, with three measures of success in mind:
- Total removal of prostate cancer cells
- Preservation of sexual function
- Preservation of urinary control
Traditional prostate removal approaches the gland from the outside in. SMART Surgery works from the inside out, allowing Dr. Samadi to remove the walnut-sized prostate with minimal disruption to the delicate structures that surround it.
The Cornerstones of SMART Surgery
- Preservation of the endopelvic fascia: Leaving this supportive tissue layer intact helps protect the nerves and muscles alongside the prostate.
- Protection of the urinary sphincter: Careful handling of the sphincter supports earlier and better return of continence.
- Nerve sparing without cautery: The tiny neurovascular bundles that control erections are protected by using cold scissors and clips rather than heat energy.
- Unique handling of the dorsal vein complex: This vein group is left unstitched until the end of the procedure, allowing precise control of urethral length to minimize leakage after surgery.
Learn more about each step on our SMART Surgery technique page.
SMART Surgery vs. Traditional Open Prostatectomy
SMART robotic surgery: Small incisions, a magnified 3D camera view, reduced blood loss, a blood transfusion rate near zero, and faster recovery.
Traditional open surgery: A larger incision to see and reach the prostate by hand, more blood loss with a higher chance of transfusion, and typically a longer recovery and catheter time.
Advantages of SMART Surgery
- Cancer control: Complete removal of the prostate allows most men to achieve an undetectable PSA, providing lasting peace of mind.
- Continence: Sphincter and urethral length preservation support recovery of bladder control.
- Sexual function: Heat-free nerve sparing protects the nerves responsible for erections, with younger men often recovering function more fully.
- Faster recovery: Most patients go home the day after surgery and return to normal activities sooner than with open surgery.
Following post-operative guidelines, including pelvic floor exercises and penile rehabilitation, plays an important role in achieving the best results.
How Long Does SMART Surgery Take?
Dr. Samadi’s experience allows him to complete SMART Surgery efficiently, reducing time under anesthesia and blood loss. Most patients go home the day after surgery with a urinary catheter, which is typically removed about a week later.
Who Is a Candidate?
SMART Surgery is generally recommended for men with prostate cancer that is confined to the gland and who are healthy enough for surgery. Dr. Samadi reviews your PSA, biopsy results, imaging, and goals to determine the best option. Read about the prostate cancer treatment trifecta and robotic surgery, or call Prostate Cancer 911 at (212) 365-5000 to schedule a consultation.
Related Care and Resources at Prostate Cancer 911
SMART Surgery for Prostate Cancer FAQs
How is SMART Surgery different from other robotic prostatectomies?
SMART Surgery approaches the prostate from the inside out and preserves the endopelvic fascia, urinary sphincter, and neurovascular bundles, using cold scissors and clips rather than cautery near the nerves.
Does Dr. Samadi perform the entire surgery himself?
Yes. Dr. Samadi performs every SMART Surgery himself from start to finish.
Why avoid cautery during nerve sparing?
Heat energy can damage the tiny nerves that control erections. Using cold scissors and clips helps protect sexual function.
Will I need a blood transfusion?
Blood loss with SMART robotic surgery is low, and the need for transfusion is rare compared with open surgery.
How soon can I go home after SMART Surgery?
Most patients go home the day after surgery.
Will my PSA be undetectable after surgery?
After complete removal of the prostate, most men achieve an undetectable PSA. Regular PSA tests monitor for any recurrence.
How do I find out if SMART Surgery is right for me?
Call (212) 365-5000 or request an appointment to have Dr. Samadi review your case.
Schedule Your Consultation With NYC’s Leading Urologist
Take control of your health today. Whether you are seeking a second opinion or experiencing symptoms like hematuria, Dr. David Samadi and the team at Prostate Cancer 911 are here to provide world-class care in Midtown Manhattan.
Request an AppointmentOffice Location: 485 Madison Ave, 21st Floor, New York, NY 10022
Phone: (212) 365-5000