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FAQs |
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Preoperative |
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How do I
prepare for the surgery? Generally, a thorough medical
history and physical, lab work and EKG are performed before
the surgery. Additional clearance from a specialist may
be required. Prior to the surgery, a bowel preparation
may be given. |
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Should I
bank my own blood?? No. One of the benefits of robotic
surgery is reduced blood loss. Outside of exceeding rare
instances, transfusions are not necessary. |
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Will I be
sterile?? Yes, the operation will render the patient sterile.
If fertility is an issue, sperm banking can be provided. |
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Operative |
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I have heard
the robotic surgery is experimental, and 'open' surgery
is a better operation - is this true?? We do not believe
so. We came into our robotic experience skeptical as well
having done thousands of open prostatectomies. In fact,
our physicians have published chapters on the open operation.
However, we feel technology has made this operation better.
Results are improved and recovery is quicker. |
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Will you
take my lymph nodes out?? The answer depends on your cancer.
Generally, a lymph node dissection is not necessary. If,
however, your cancer is higher risk, a dissection can
be performed. |
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Will my nerves
be spared?? Again the answer depends on your cancer. We
view the three goals of the operation as being cancer
control, then urinary control, and finally sexual function.
Depending on the cancer, we may save both, one or neither
nerves. As our understanding of the anatomy has increased we can offer patients with even aggressive cancers different incremental degrees of nerve sparing. |
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Do you employ
special techniques to spare the nerves??We use our own modification of several techniques including the ‘veil’, ‘superveil’ and other techniques. We do not use cautery which risks burning the nerves. Experience is key, and this is often the part of the operation we spend the most time on. |
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What happens
if the robot breaks?? This can happen infrequently. In
some cases the operation can be completed laparoscopically.
However, if an optimal result cannot be attained, we will
convert to anopen operation. |
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Post
operative |
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How long
will I stay in the hospital?? Most patients leave the
hospital the day after surgery. We will keep patients
until they are comfortable going home. |
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How long
will my catheter be in?? The catheter is normally removed
anywhere from 7-14 days after the operation. |
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What happens
when the catheter comes out, when will I regain urinary
control?? Most patients will experience a degree of incontinence
when the catheter is removed. This will require the use
of pads. Although, the davinci prostatectomy results in
an earlier return of urinary control, this time is not
predictable. At the time of your first followup appointment
( 1 month after catheter removal), we expect substantial
if not complete improvement. |
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When will
I regain sexual function?? Generally, return of sexual
function is less predictable than urinary function. Erections
can take up to 18 months for full recovery. We have a
sexual rehabilitation program which can facilitate this
process. |
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I have seen/
heard of centers claiming immediate urinary control following
catheter removal and 85-90% return of sexual function
- can you make these guarantees?? The answer is no. The
only thing we can guarantee is an outstanding technical
operation and one on one personalized care. Despite this,
we know some people will have bothersome urinary control
and others will have erectile dysfunction. Prior to your
operation, we will make an estimate on the likelihood
of you having problems - especially with regard to sexual
function (much of this is based on any medical problems
such as diabetes or hypertension which predispose to erectile
dysfunction). Young, healthy patients do best. |
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