One of Largest Studies of Its Kind Led by Dr. Ketan K. Badani, Newly Appointed Director of Robotic Surgery at NewYork-Presbyterian Hospital/Columbia University Medical Center
Dec 18, 2007
Prostate cancer patients receiving robotic prostatectomy—an advanced procedure to remove the prostate using a surgical robot—have excellent outcomes five years after surgery.
The results of what may be the largest and longest study of its kind are published in a recent issue of the journal Cancer, and led by Dr. Ketan K. Badani, the newly appointed director of robotic surgery at NewYork-Presbyterian Hospital/Columbia University Medical Center and assistant professor of urology at Columbia University College of Physicians and Surgeons. Previously, Dr. Badani was a clinical fellow in robotic and laparoscopic urologic oncology at Henry Ford Hospital in Detroit, where the 2,766 procedures followed in the investigation were conducted over a six-year period.
Dr. Badani says, "We found that in highly experienced hands, the results after robotic surgery are outstanding for cancer control, with minimal complications and few side effects of urinary incontinence and sexual dysfunction."
"In addition, blood loss is far less than with traditional surgery. This, along with minimizing trauma to the body tissues, translates into short hospital stays, and more importantly, quick recovery—allowing patients to resume their regular activities, whether that means going for a run or playing 18 holes of golf," adds Dr. Badani, who has personally performed more than 700 of the robotic procedures.
Specific study findings include the following:
- Ninety-three percent (93%) of patients achieved normal urinary function, with a median time of complete control of three weeks.
- Only slightly more than seven percent (7.2%) of patients had recurrence of prostate cancer symptoms (presence of prostate specific antigen, or PSA). Less than one percent (0.5%) of patients died during 71 months of follow-up.
- Nearly 80 percent (79.2%) of patients reported normal sexual function.
The study also compared clinical outcomes of the first 200 patients with that of the final 200 patients to see if there were improvements. They found a reduced amount of blood loss and fewer cases of positive surgical margins (4 percent, down from 7 percent)—when the initial cut does not cut away all of the cancerous tissue. The surgery also was performed faster (131 minutes vs. 160 minutes).
"With five years of follow-up, we can now see that, not only is robotic prostate surgery safe and effective, but it continues to improve," says Dr. Badani. "As with any highly technical operation, the study points to the importance of experience. With the knowledge and practice of many procedures, outcomes for patients improve. NewYork-Presbyterian/Columbia is one of only a few premier centers that can offer this level of specialized surgery to patients."
Dr. Badani has helped pioneer novel techniques to preserve sexual potency in men undergoing robotic prostatectomy while optimizing cancer control. He has performed live robotic demonstrations at both national and international meetings and has lectured and published extensively on outcomes of patients undergoing robotic surgery. He received his medical degree from Case Western Reserve University School of Medicine in Cleveland, Ohio, and completed both his urologic residency and fellowship in robotic and laparoscopic urologic oncology at the Vattikuti Urology Institute at Henry Ford Hospital in Detroit.
The Cancer study is co-authored by Drs. Sanjeev Kaul and Mani Menon—both of the Henry Ford Hospital in Detroit.
NewYork-Presbyterian/Columbia offers a comprehensive urologic surgery program with robotic surgery available for robotic prostatectomy, robotic nephrectomy (kidney), robotic cystectomy (bladder) and robotic adrenal gland surgery. In addition to Dr. Badani, members of the robotic urologic surgery team include Drs. Mitchell C. Benson, James M. McKiernan, Erik Goluboff and Carl A. Olsson.
During robotic prostatectomy, the physician makes five to six small incisions in the abdomen, through which surgical instruments and a tiny stereoscopic camera are inserted. The camera improves visibility, and robotic arms make for easier suturing.
Robotic prostatectomies make use of Intuitive Surgical's da Vinci™ Surgical System, which has been approved by the FDA for a number of innovative clinical procedures employed at NewYork-Presbyterian Hospital.
Prostate cancer is the second most common cancer death after lung cancer. Each year, over 200,000 Americans are diagnosed with prostate cancer, and as many as 32,000 will die from the disease.
NewYork-Presbyterian Hospital—based in New York City—is the nation's largest not-for-profit, non-sectarian hospital, with 2,242 beds. It provides state-of-the-art inpatient, ambulatory and preventive care in all areas of medicine at five major centers: NewYork-Presbyterian Hospital/Weill Cornell Medical Center, NewYork-Presbyterian Hospital/Columbia University Medical Center, Morgan Stanley Children's Hospital of NewYork-Presbyterian, NewYork-Presbyterian Hospital/Allen Pavilion and NewYork-Presbyterian Hospital/Westchester Division. One of the largest and most comprehensive health-care institutions in the world, the Hospital is committed to excellence in patient care, research, education and community service. It ranks sixth in U.S.News & World Report's guide to "America's Best Hospitals," ranks first on New York magazine's "Best Hospitals" survey, has the greatest number of physicians listed in New York magazine's "Best Doctors" issue, and is included among Solucient's top 15 major teaching hospitals. The Hospital is ranked with among the lowest mortality rates for heart attack and heart failure in the country, according to a 2007 U.S. Department of Health and Human Services (HHS) report card. The Hospital has academic affiliations with two of the nation's leading medical colleges: Weill Cornell Medical College and Columbia University College of Physicians and Surgeons.
Columbia University Medical Center
Columbia University Medical Center provides international leadership in pre-clinical and clinical research, in medical and health sciences education, and in patient care. The medical center trains future leaders and includes the dedicated work of many physicians, public health professionals, dentists, nurses, and scientists at the College of Physicians and Surgeons, the Mailman School of Public Health, the College of Dental Medicine, the School of Nursing, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. For more information, visit www.cumc.columbia.edu.