All Discuss..

WELCOME TO THIS EDITION OF HEALTHLINE.

I'M DOCTOR KEVIN SODEN.

WHAT WOULD YOU SAY IF YOUR DOCTOR TOLD YOU THAT YOU NEEDED AN OPERATION AND THE PROCEDURE WOULD BE PERFORMED BY A ROBOT?

IT'S NOT SCIENCE FICTION ANYMORE.

IT'S SCIENCE FACT. TAKE A LOOK.

(NARRATOR) JIM BACOT WAS FACING A PROBLEM.

AN AGGRESSIVE FORM OF PROSTATE CANCER.

AT 55 HE'S FACING IT YOUNGER THAN MOST OF THE MORE THAN 200,000 MEN WHO WILL BE DIAGNOSED WITH THE DISEASE THIS YEAR.

A HOUSE BUILDER WHO LIVES WITH HIS WIFE IN A MODEL HOME HE BUILT HIMSELF, JIM IS METHODICAL. HE'S EVEN BEEN REGULARLY TESTED FOR PROSTATE CANCER SINCE AGE 38.

I DON'T EVEN WANT TO GO DOWN THE ROAD OF THINKING ABOUT THAT I WOULD'VE MISSED THIS FOR 2 YEARS AND THEN BEEN FACED WITH THE FACT THAT THIS IS SPREAD IN THE PELVIC REGION TO MANY OTHER AREAS.

IT JUST GIVES YOU A BAD IDEA.

(NARRATOR) JIM'S DILIGENCE MEANS DOCTOR JONATHON HWANG HAS ONLY TO REMOVE THE CANCEROUS PROSTATE.

THE O.R. TEAM WILL HAVE GIANT HELP BATTLING THIS SMALL GLAND.

A 7 X 7 FOOT FOUR-ARMED METAL MONSTER...NAMED FOR A RENAISSANCE GENIUS.

I HAD CALLED DOCTOR HWANG 'CAUSE HE'S ONE OF THE LEADING SURGEONS THAT USE THE ROBOTIC METHOD.

I'M IN THE BUILDING INDUSTRY AND ACCURACY DOES PLAY A BIG PART.

AND ESPECIALLY WHEN YOU GO INTO...HAPPENS TO BE MY PROSTATE YOU KNOW I WANT ABOUT AS GOOD AS YOU CAN GET.

(NARRATOR) AND THE STATE OF THE ART IS COMPUTER-AIDED ROBOTIC RADICAL PROSTATECTOMY.

ONE OF THE MAIN REASONS WHY PATIENTS ELECT ROBOTIC SURGERY OVER A STANDARD OPERATION.

BECAUSE IT REALLY GIVES THEM THE ABILITY TO RETURN TO WORK.

RESUME THE NORMAL LIFE THEY HAD PRIOR TO THE DIAGNOSIS OF PROSTATE CANCER.

GOOD.

KEEP COMING IN PLEASE.

KEEP COMING IN.

IN PROSTATE CANCER SURGERY WE HAVE THREE PRIORITIES.

OUR NUMBER ONE GOAL IS: CANCER ERADICATION.

TO REMOVE ALL CANCER CELLS.

THE SECOND GOAL IS: CONTINENCE.

AND THE THIRD IS: ERECTILE FUNCTION.

(NARRATOR) PRESERVING THOSE FUNCTIONS IS TRICKY IN THE CROWDED NEIGHBORHOOD WHERE THE WALNUT-SIZE PROSTATE LIES AT THE BOTTOM OF THE ABDOMEN.

EVEN THE MOST PROFICIENT SURGEON CAN HAVE A SLIP OF THE SCALPEL THAT CAN SEVERELY IMPACT A MAN'S QUALITY OF LIFE.

THAT'S WHERE DA VINCI COMES IN.

(DOCTOR SPEAKING) NICE, NICE, NICE.

FANTASTIC.

(NARRATOR) A ROBOTIC CAMERA PROVIDES A CLOSE-UP VIEW INSIDE THE BODY.

THOUGH IN A DARKENED CORNER OF THE O.R., DOCTOR HWANG STILL HAS A FRONT-ROW SEAT.

HE'S PEERING INTO JIM'S INSIDES IN 3-D.

THE CAVITY HAS BEEN FILLED WITH CARBON DIOXIDE TO SEPARATE THE ORGANS A BIT.

AND GIVE DA VINCI MORE ELBOW ROOM.

WITH HIS SURGICAL TEAM AT THE ROBOT'S SIDE, DOCTOR HWANG DIRECTS THE ACTION.

DOCTOR HWANG MANIPULATES THE HANDLES THAT TELL THE ROBOT WHERE TO CUT.

THE ROBOT RESPONDS WITHOUT EVEN THE SLIGHTEST TREMORS THAT CAN EMANATE FROM THE HUMAN HAND.

THIS PRECISION MAKES THE OPERATION SAFER AND LESS TRAUMATIC FOR THE PATIENT.

ALONG WITH BLOOD, THE ROBOTIC PROCEDURE CAN SAVE MORE NERVE FUNCTION THAN STANDARD SURGERY THROUGH A LARGE OPEN INCISION.

(DOCTOR) BUT IN OPEN SURGERY YOU DON'T SEE THIS PART.

YOU DO EVERYTHING BY FEEL BECAUSE YOU CAN'T SEE DOWN IN THIS DEEP PELVIS.

(NARRATOR) DOCTOR HWANG REMOVES ONLY THE NERVE ALONG THE CANCEROUS SIDE OF THE PROSTATE.

DOCTOR: LIKE THIS IS THE SPHINCTER RIGHT HERE.

WE SAVE THE NERVE...SEE THAT NERVE?

THAT'S THE NERVE DOWN THERE.

SO YOU HOPEFULLY DON'T RESULT IN INTACT SEXUAL FUNCTION.

IN TERMS OF CONTINENCE THE FACT THAT WE DIDN'T DISTURB ANY OF THAT SPHINCTER THEY REALLY DO GAIN THEIR CONTINENCE EXTREMELY FAST.

I THINK HE'LL BE VERY HAPPY ABOUT ABLE TO RETURN TO WORK WITHIN 2-3 WEEKS RATHER THAN 6 WEEKS FOLLOWING OPEN SURGERY.

THE ROBOT REALLY MAKES ME A FANTASTIC SURGEON.

WITHOUT SOUNDING TOO CONCEITED.

BECAUSE I REALLY FEEL THAT I NOW REALLY UNDERSTAND THE ANATOMY AROUND THE PROSTATE AND I CAN SAFELY REMOVE THE CANCEROUS GLAND AND PRESERVE ALL THE NORMAL STRUCTURES.

(DOCTOR SPEAKING) ON THE RIGHT SIDE WE ACTUALLY LEFT THE NEUROBUNDLE.

THIS IS THE BUNDLE RIGHT HERE.

THAT'S THE BUNDLE ON THE CANCER.

AND YOU CAN FEEL THE CANCER WHEN YOU FEEL AND WE HAVE A NICE BIG MARGIN.

ON THIS SIDE IT'S NICE AND CLEAN HERE BECAUSE WE SAVED THE NERVE ON THE LEFT SIDE.

(NARRATOR) DOCTOR HWANG IS CONFIDENT AFTER THE OPERATION.

HI MRS. BACOT.

SO EVERYTHING WENT WELL.

IT WENT EXACTLY AS PLANNED.

WE WERE ABLE TO EASILY SAFE THE NERVE ON ONE SIDE AND THE SIDE WHERE HE HAD CANCER.

WE DID INTENTIONALLY GO A LITTLE WIDER TO MAKE SURE THAT ALL THE CANCER WAS REMOVED.

(NARRATOR) THE SURGERY HAS SAVED JIM'S LIFE.

STILL IT WILL BE WEEKS BEFORE JIM STARTS TO GET AN IDEA OF THE QUALITY OF THE LIFE IT HAS LEFT HIM.

JIM'S DOCTOR WAS CONFIDENT.

BUT IT TAKES SEVERAL WEEKS TO DETERMINE THE FINAL OUTCOME AND ANY POSSIBLE SIDE EFFECTS.

FORTUNATELY HIS SURGEON, DOCTOR JONATHON HWANG OF WASHINGTON HOSPITAL CENTER IS HERE TODAY TO GIVE US A FULL REPORT.

AND WE HAVE ANOTHER SURPRISE VISITOR.

JIM BACOT.

JIM, HOW ARE YOU FEELING TODAY AFTER THAT SURGERY?

IT'S BEEN A SHORT AMOUNT OF TIME BUT I REALLY FEEL GOOD.

I FEEL CONFIDENT ABOUT IT TOO.

THAT'S EVEN MORE IMPORTANT.

THAT'S RIGHT.

DOCTOR HWANG HOW WAS IT?

I MEAN HERE YOU ARE ON FILM DOING THIS WITH...YOU KNOW HOW DID JIM'S SURGERY GO AS FAR AS YOU'RE CONCERNED?

WELL CERTAINLY, I MEAN HIS SURGERY WENT BEAUTIFULLY.

WE HAD A SPECIFIC PLAN BASED ON HIS DIAGNOSIS AND STAGING AND WE'RE ABLE TO REMOVE THE PROSTATE, PRESERVE THE NERVE AS WE INTENDED TO; THE SPHINCTER REMAINED NICE AND INTACT SO YOU KNOW CERTAINLY HIS RECOVERY REFLECTS THE SUCCESS OF THE OPERATION.

AND THUS FAR HE'S BEEN DOING REALLY WELL.

SO WE'RE VERY PLEASE WITH THE OUTCOME.

NOW WHAT ARE SOME OF THE POTENTIAL SIDE-EFFECTS FOLLOWING PROSTATE SURGERY?

NOT JUST WITH THE ROBOTIC BUT WITH GENERAL PROSTATE SURGERY?

THE TWO KEY MAIN ISSUES RELATED TO PROSTATE CANCER SURGERY IS INCONTINENCE AND ERECTILE DYSFUNCTION THAT CAN ENSUE AFTER TH PROSTATE HAS TWO ROLES IN THE BODY: ONE BEING OF CONTINENCE.

ALSO IT'S VERY CLOSE TO THE NERVES THAT CONTROL THE SEXUAL FUNCTION.

IF THESE STRUCTURES ARE INJURED OR DAMAGED DURING THE OPERATION CERTAINLY THAT CAN HAVE A SIGNIFICANT IMPACT IN THE QUALITY OF LIFE.

WHICH WE TRY TO MAINTAIN AND PRESERVE WHEN WE ACCOMPLISH THE OPERATION.

JIM WHAT WAS IT LIKE FOR YOU THINKING ABOUT HAVING KIND OF "ROBO THE ROBOTIC SURGEON" GOING INTO YOU?

WELL IT'S MORE AND EXACT AND PRECISE PROCEDURE.

YOU KNOW ONCE I GOT THE CALL FROM DOCTOR SAYS THAT YOU HAVE THIS...LOOKING BACK ON IT YOU RESEARCH ALL THIS.

AND YOU KNOW VERSUS TRADITIONAL SURGERY ROBOTIC IS A MUCH MORE PRECISE AND EXACT AND MORE COMFORTABLE FEELING TO THE GUY...IT HAPPENS TO BE MY PROSTATE I WANT THE BEST I CAN GET.

YES IT'S VERY MUCH MORE.

GREAT.

WHEN HEALTHLINE RETURNS WE'LL HEAR THE FULL PROGNOSIS.

AND LATER THE PROMISE FOR A ROBOTIC REVOLUTION.

WE'LL BE RIGHT BACK.

WELCOME BACK TO HEALTHLINE.

WE'RE TALKING ABOUT ROBOTIC SURGERY WITH DOCTOR JONATHON HWANG AND HIS PATIENT JIM BACOT.

DR. HWANG TELL ME ABOUT HOW IS JIM DOING AS FAR AS YOU'RE CONCERNED A MONTH AFTER SURGERY?

HE'S EXACTLY 19 DAYS FROM HIS OPERATION AND HE'S CERTAINLY CLOSE TO BEING NORMAL.

REALLY IF HE REALLY WANTS TO HE CAN RETURN TO WORK AND RESUME LIGHT ACTIVITIES WITHOUT ANY LIMITATIONS.

WITHIN ABOUT A WEEK OR TWO HE CAN RESUME ALL ACTIVITIES WITHOUT ANY LIMITATIONS.

SO CERTAINLY HE'S RIGHT ON THAT CURVE AS WE HAVE EXPECTED.

AND ALL ACTIVITIES MEANING SEXUAL FUNCTION AS WELL?

WELL SEXUAL FUNCTION USUALLY TAKES ABOUT 3 MONTHS TO 6 MONTHS BEFORE RETURNING.

ALTHOUGH WE SAVED THE NERVES THEY ALWAYS GO INTO A STATE OF SHOCK.

WE SOMETIMES USE MEDICATIONS TO TRY TO STIMULATE THE NERVES BUT ACTIVITIES AS IN DAILY ACTIVITIES THAT YOU DO RELATED TO WORK OR JUST THE USUAL ACTIVITIES THAT YOU DO.

AND WHAT ADVANTAGE DOES ROBOTIC SURGERY OFFER OVER CONVENTIONAL PROSTATE SURGERY?

WELL I THINK THERE ARE SEVERAL ADVANTAGES.

REALLY THE ROBOT HAS BEEN MADE TO DUPLICATE WHAT WE DO WITH OUR HANDS BUT MUCH MORE PRECISELY.

AND ALSO THROUGH MUCH SMALL INCISIONS.

AND WHAT THAT TRANSLATES INTO IS THAT THE PATIENTS INCISIONS ARE SMALLER SO THEIR CONVALESCENCE ARE FASTER.

THEY'RE ABLE TO RETURN TO WORK SOONER AND ALSO BECAUSE ALL THE MOVEMENTS ARE MUCH MORE PRECISE WE CAN REALLY PRESERVE THE NORMAL STRUCTURES I THINK MUCH MORE EFFECTIVELY.

DO YOU USE VIAGRA AFTER SURGERY?

THIS IS ONE OF THE THINGS THAT I'VE HEARD PATIENTS TALK ABOUT.

AND JUST KIND OF SURPRISED ME.

WHY DO YOU DO THAT?

WELL THERE WAS A RECENT STUDY THAT CAME OUT FROM UCLA LAST YEAR AND WHAT IT HAS SHOWN IS THAT WHEN YOU USE PD-5 INHIBITORS AND VIAGRA BELONGS TO THAT GROUP YOU CAN STIMULATE THE NERVES EARLY.

IT ALSO PRODUCES BIGGER BLOOD FLOW TO THE PENILE TISSUE AND IT HELPS PREVENT ERECTILE DYSFUNCTION THAT OFTEN IS SEEN AFTER PROSTATE CANCER SURGERY.

SO THAT'S ONE REALLY BIG BENEFIT FOR MEN OBVIOUSLY?

IT APPEARS TO BE.

IT APPEARS TO BE.

JIM YOU'RE AMAZING TO ME.

I WOULD NEVER HAVE GUESSED IT'S ONLY BEEN SUCH A SHORT WHILE AFTER SURGERY.

HOW DO YOU REALLY FEEL RIGHT NOW?

I TRULY FEEL GOOD.

WHICH YOU KNOW TALKING TO OTHER PEOPLE IN DIFFERENT PARTS OF THE WORLD THAT I KNOW THAT HAS SURGERY IT LAYS UP A WHOLE LOT LONGER.

LIKE JONATHON SAID IT'S 19 DAYS AND I FEEL GOOD.

I WALK AROUND.

IT'S VERY COMFORTING.

AND GUYS NEED TO KNOW THAT BECAUSE YOU KNOW THAT'S A SCARY SUBJECT WHEN YOU SAY PROSTATE.

IT'S KIND OF AN UNDER-THE-BELT THING AND GUYS DON'T TALK ABOUT IT.

AND GUYS DON'T GET CHECKED UNLESS THEY'RE SICK AND HAVE TO GO TO THE DOCTOR.

IT'S JUST NOT DONE.

I REALLY WANT THIS TO BE A SEGMENT THAT THESE GUYS HAVE A CHANCE TO TAKE A LOOK AT IT AND GO GET A BLOOD TEST AND CHECK THEIR PSA BECAUSE THIS HAD NO SIGNS.

I HAD NO PROBLEMS IN URINATION OR ANYTHING LIKE THAT.

AND BELIEVE ME, IT WAS A TOTAL SURPRISE.

AND IT'S LIKE GETTING GUT SHOT.

I HAVE TO TELL YOU MY BROTHER JUST HAD PROSTATE SURGERY.

HE'S FIVE YEARS YOUNGER AND HE HAD ROBOTIC SURGERY FOR THOSE VERY SAME REASONS.

NOW I SAW IN THE VIDEO SEGMENT DOCTOR HWANG THAT YOU ACTUALLY WERE GOING SIDE-TO-SIDE VERY CAREFULLY TO TRY AND SPARE THE NERVES AS MUCH AS POSSIBLE.

RIGHT.

RIGHT.

NOW IS THAT EASIER TO DO WITH ROBOTIC SURGERY?

I BELIEVE SO.

REALLY THE NERVES ARE SO CLOSE TO THE SURFACE OF THE PROSTATE...IT'S SOMETIMES VERY DIFFICULT TO FIND THE RIGHT PLANE THAT SEPARATES THE NERVES FROM THE SURFACE OF THE PROSTATE.

WITH THE ROBOT YOU HAVE ABOUT AS SOON AS YOU SIT DOWN AND LOOK THROUGH YOU REALIZE WOW YOU'RE SEEING EVERYTHING LIVE BUT ABOUT TEN OR 15 TIMES THE NORMAL MAGNIFICATION.

NOW DO YOU NEED BOTH NERVES?

AREN'T THERE TWO NERVES IN THE PROSTATE?

THERE'S TWO NERVES.

THERE'S NERVES ON EACH SIDE OF THE PROSTATE.

IDEALLY YOU WOULD LIKE TO PRESERVE BOTH NERVES TO MAINTAIN AND TO ENSURE NORMAL SEXUAL FUNCTION.

UNFORTUNATELY IN CERTAIN CASES WE DO NEED TO GO A LITTLE WIDER OR SACRIFICE A NERVE BUNDLE IF WE THINK THE CANCER IS TOO CLOSE OR HAS INVADED INTO THE NERVE BUNDLE.

WHEN YOU SAVE ONE NEUROVASCULAR BUNDLE YOUR CHANCE OF MAINTAINING OR REGAINING NORMAL SEXUAL FUNCTION RANGES SOMEWHERE BETWEEN 50-60%.

VERSUS IF YOU PRESERVE BOTH NERVE BUNDLES IT SHOULD BE ABOUT 80-90%.

JIM ANY ADVICE FOR YOU KNOW PATIENTS WHO ARE UNDERGOING OR POTENTIALLY UNDERGOING PROSTATE SURGERY?

GUYS SAY "YEAH I HAVE A PROSTATE THAT COMES WITH THE REST OF THE EQUIPMENT" BUT THEY DON'T REALLY KNOW THE FUNCTIONS OF IT.

AND ERECTILE FUNCTION IS PART OF THAT YOU KNOW.

THAT'S PART OF THE PACKAGE WHEN THE DOCTOR STARTS TALKING TO YOU THE FIRST THINGS LIKE "AM I GOING TO HAVE A SEX LIFE AFTER THIS IS ALL DONE?" YOU KNOW IT'S LIKE JONATHON MENTIONED ONE NERVE BUNDLE COULD BE LOST BUT YOU STILL HAVE THE OTHER ONE AND THEY DO HAVE MEDICATIONS THAT HELP THE GUYS MAINTAIN AND BRING BACK A NORMAL SEXUAL FUNCTION WHICH IS IMPORTANT TO HIM.

ESPECIALLY AT MY AGE.

AND GUYS NEED TO KNOW THAT.

AND INCONTINENCE IS THE OTHER YOU KNOW THAT'S...WHAT HAPPENS WHEN THEY CUT ALL THIS OUT.

WHAT HAPPENS AFTER SURGERY?

WHAT AM I GOING TO BE LIKE TWO MONTHS DOWN THE ROAD?

IT'S DEFINITELY A SCARY FEELING.

JIM THANKS FOR JOINING US TODAY AND SHARING YOUR STORY.

I MEAN IT'S MOST ENCOURAGING FOR EVERYBODY AND WE WISH YOU THE BEST IN RETURN TO RECOVERY.

THANK YOU.

DOCTOR HWANG STAY WITH US.

I'M GOING TO ASK YOU SOME MORE QUESTIONS ABOUT ROBOTIC SURGERY WHEN WE COME BACK.

SO ALL OF YOU, PLEASE STAY TUNED.

HI, WELCOME BACK TO HEALTHLINE.

WE'VE ALREADY SEEN HOW ROBOTS ARE TRANSFORMING PROSTATE SURGERY.

BUT DID YOU KNOW THAT ROBOTIC ASSISTED PROCEDURES HAVE BEEN GROWING AT A STAGGERING RATE?

TENS OF THOUSANDS OF ROBOTIC PROCEDURES ARE PERFORMED EACH YEAR IN THE US.

WE'RE HERE WITH DOCTOR JONATHON HWANG, DIRECTORY OF ROBOTIC SURGERY AT WASHINGTON HOSPITAL CENTER AND GEORGETOWN UNIVERSITY.

DOCTOR HWANG DOES IT MAKE IT EASIER USING THESE ROBOTS TO MANEUVER IN TINY PLACES?

IT REALLY DOES.

OBVIOUSLY IN CERTAIN SPACES IN THE BODY IT'S NOT EASY FOR US TO PLACE OUR HANDS DEEP IN THE PELVIS FOR EXAMPLE.

WITH A ROBOT WHICH IS REALLY A MINIATURIZATION OF OUR HANDS YOU CAN REALLY REACH EVERY CREVICE, EVERY SURFACE AND EVERY AREA WITHIN THE BODY WITHOUT ANY LIMITATIONS.

ONCE YOU START USING...GET COMFORTABLE WITH IT YOU REALLY SHOULD NOT HAVE ANY LIMITATION IN TERMS OF REACHING THE AREA THAT YOU'D LIKE TO REACH.

NOW I SAW YOU IN THE VIDEO SEGMENT AND IT LOOKED LIKE YOU WERE ON A STAR WARS VIDEO MONITOR ALMOST OR SOMETHING LIKE THAT.

DO PEOPLE WHO ARE GOOD AT VIDEO GAMES ARE THEY BETTER AT THIS KIND OF THING?

WELL THERE WAS A NEWS ARTICLE THAT CAME OUT IN I BELIEVE THAT WAS THE NEW YORK TIMES AND THAT DID SHOW THAT PEOPLE WHO USED TO PLAY A LOT OF VIDEO GAMES WERE ABLE TO PICK UP THESE MINIMALLY INVASIVE SURGICAL TECHNIQUES FASTER.

AS A MATTER OF FACT WE ACTUALLY RAN A LITTLE EXERCISE WITH MEDICAL STUDENTS WHO HAVE NEVER...WHO HAVE NOT HAD ANY PRIOR SURGICAL EXPERIENCE.

WE HAD ONE GROUP PLAY VIDEO GAMES FOR ABOUT 1/2 AN HOUR BEFORE USING THE ROBOT...

ON AN EXERCISE VERSUS A GROUP WITHOUT AND YOU COULD CERTAINLY SEE THAT THE ONES WHO PLAY THE VIDEO GAME AS A WARM-UP HAD A QUICKER PICK-UP OF THE ROBOTIC SURGICAL SYSTEM.

I CAN JUST SEE THAT IN THE OPERATING ROOM NOW THE PATIENT SAYING WHAT IS THIS DOCTOR DOING NOW?

RIGHT.

I HAVE TO TELL YOU THOUGH I MEAN LOOKING AT THE ROBOTIC SURGERY AND EVERYTHING AND YOU SAY TO YOURSELF "WELL WHY WOULDN'T YOU HAVE THIS DONE?" SO HOW DOES A PATIENT KNOW YOU KNOW IF HE NEEDS PROSTATE SURGERY WHAT DOCTOR IS SKILLED AND ABLE TO DO THIS KIND OF SURGERY?

I THINK THE MOST IMPORTANT THING TO DO IS TO REALLY BE DIRECT WITH THE DOCTOR.

WITH THE SURGEON.

I THINK IT'S IMPORTANT TO ASK THE SURGEON'S EXPERIENCE.

I THINK IT'S COMPLETELY REASONABLE TO ASK A SURGEON THE NUMBER OF CASES THEY HAVE DONE BECAUSE IT'S REALLY THE SURGEON'S EXPERIENCE USING THE ROBOT THAT DICTATES SURGICAL OUTCOMES.

I'M GONNA ASK YOU A TOUGH QUESTION.

WHY WOULD ANYONE GO THROUGH CONVENTIONAL SURGERY FOR PROSTATE YOU KNOW RATHER THAN HAVING THE ROBOTIC SURGERY?

WELL I'M QUITE BIASED ON THIS TOPIC BUT I DON'T THINK THERE SHOULD BE ANY REASON TO CHOOSE OPEN OVER ROBOTIC SURGERY.

I THINK AS LONG AS YOU FIND A SURGEON WHO'S QUITE FACILE WITH THE ROBOTIC SYSTEM, WHO HAS DONE SEVERAL HUNDRED OF ROBOTIC PROSTATECTOMY'S.

I THINK CLEARLY THIS IT THE WAY TO GO.

NOW ARE SOME PEOPLE AFRAID OF THIS NEW TECHNOLOGY?

ARE PATIENTS LESS LIKELY TO ACCEPT THIS BECAUSE IT'S SO NEW?

I THINK THAT'S A REASONABLE CONCERN ON THE PATIENT'S PART.

CERTAINLY WITH ANY TECHNOLOGY THERE IS A POSSIBILITY THE SYSTEM MAY BREAK DOWN DURING THE OPERATION.

ALSO THE ROBOT LACKS ANY TACTILE FEEDBACK.

SO IF YOU'RE USING THE ROBOT AND NOT REALLY PAYING ATTENTION YOU CAN CAUSE GREAT DAMAGE.

AND I THINK THAT'S WHERE THE EXPERIENCE AND THE LEARNING CURVE COMES INTO PLAY.

WHY DO YOU THINK THIS FIELD IS EXPANDING SO RAPIDLY?

BECAUSE IT REALLY GIVES US AN ABILITY TO BECOME A BETTER SURGEON...WITH MORE PRECISION; IMPROVED DEXTERITY.

AS LONG AS YOU'RE A GOOD OPEN SURGEON YOU SHOULD BE ABLE TO TRANSLATE INTO AN EXCELLENT ROBOTIC SURGEON.

I THINK AS MORE SURGEONS ET TRAINED EARLY ON I DO EXPECT THE FIELD OF ROBOTIC SURGERY WILL REPLACE MOST OF THESE OPEN SURGERIES THAT ARE BEING DONE TODAY.

DOCTOR HWANG THANKS FOR BEING HERE TODAY.

THIS IS JUST A WONDERFUL WONDERFUL SHOW THAT I KNOW WILL HELP MANY OF OUR VIEWERS, FOR SURE.

WELL THANK YOU FOR HAVING ME HERE TODAY.

WHEN HEALTHLINE RETURNS A ROBOTIC CAMERA TAKES US INSIDE THE HUMAN HEART.

STAY TUNED.

WELCOME BACK TO HEALTHLINE.

I'M DOCTOR KEVIN SODEN.

WE'VE BEEN TALKING ABOUT ROBOTIC ASSISTED PROCEDURES AND HOW THEY'RE TRANSFORMING SURGERY.

NOW WE'RE ABOUT TO WATCH AS A ROVING ROBOTIC CAMERA TAKES US INSIDE HEART BYPASS SURGERY.

THE ROBOTIC PROGRAM FOR HEART SURGERY AT THE UNIVERSITY OF MARYLAND HAS BEEN FOCUSED ON...AT LEAST FROM MY PERSPECTIVE...CORONARY BYPASS SURGERY.

AND THIS WHERE YOU HAVE BLOCKAGES IN THE ARTERIES IN YOUR HEART AND WE NEED TO DO A BYPASS PROCEDURE.

THE MOST CLASSIC EXAMPLE IS TO TAKE A MAMMARY ARTERY AND THEN WE CAN SWING THAT DOWN ONTO THE HEART AND BYPASS VESSELS ON THE FRONT OF THE HEART.

WHEN YOU DO TRADITIONAL SURGERY 80% OF THE TIMES THE HEART IS STOPPED.

AND THE PURPOSE OF THAT IS SO YOU CAN SEW TO A HEART THAT IS NOT MOVING.

WHEN YOU DO THE ROBOTIC SURGERY AND WE OPERATE ON THE LEFT CHEST WE ACTUALLY...THE ARTERY IS SITTING RIGHT UNDERNEATH WHERE OUR INCISION IS.

SO WE THEN ARE MOVING OUR INCISION OVER TO WHERE THE ARTERY IS THAT WE WANT TO BYPASS.

SO THEN NOW WE CAN JUST...I JUST TAKE A LITTLE FORK AND PUT IT DOWN ON THE HEART.

AND THE HEART'S VERY STABLE WHEN I DO THAT SO THAT THE BLOOD PRESSURE'S PERFECTLY FINE.

USE OF THE BYPASS MACHINE IS SAFE BUT IN ELDERLY PATIENTS IT CAN BE ASSOCIATED WITH COMPLICATIONS AT A HIGHER RATE THAN IN YOUNGER PATIENTS.

SO I REALLY LIKE THIS PROCEDURE FOR AN ELDERLY PATIENT.

YOU DON'T SEE PATIENTS UNDERGOING THE STERILE INCISIONS GETTING BACK TO WORK IN TWO WEEKS.

IT JUST DOESN'T HAPPEN.

DOESN'T HAPPEN TO EVERYONE OF MY ROBOT CASES BUT THE FACT THAT IT HAPPENS AT ALL TELLS YOU THERE'S SOMETHING SPECIAL ABOUT THIS-- THIS PARTICULAR PROCEDURE.

WHO WOULD'VE THOUGHT THAT ROBOTS WOULD DO HEART SURGERY IN OUR LIFETIME?

WE'RE HERE WITH DOCTOR FARSAD NAJAM ASSOCIATE DIRECTOR OF CARDIAC SURGERY AT GEORGE WASHINGTON UNIVERSITY HOSPITAL.

DOCTOR NAJAM WELCOME TO THE SHOW.

AND JUST TELL ME HOW HAS ROBOTICS TRANSFORMED HEART SURGERY?

WHEN YOU TALK ABOUT OPEN-HEART SURGERY AND THE FIRST VISION WHICH COMES TO YOUR MIND IS A BIG INCISION...YOU'LL CRACK THE CHEST AND IT'S A BIG OPERATION.

BUT IF YOU'RE ABLE TO DO THE SAME OPERATION THROUGH SMALLER INCISIONS THAT WILL CHANGE DRAMATICALLY HOW THE PATIENTS PERCEIVE HEART SURGERY AND HOW THE PATIENT WILL DO AFTER HEART SURGERY AND WHAT IS THERE RECUPERATION.

DOES THIS MEAN LESS BLEEDING OR LESS RISK OF INFECTION AT ALL?

ABSOLUTELY.

RIGHT NOW WE HAVE TO GO THROUGH THE STERNUM TO DO BIG OPERATIONS SO IF YOU'RE ABLE TO DO THIS OPERATION THROUGH KEYHOLE INCISIONS THERE'S DEFINITELY A LOWER RISK OF BLEEDING AND INFECTION.

I CAN TELL YOU RIGHT NOW THAT'S THE ONE I WANT IF I HAVE TO GO TO BYPASS SURGERY.

ARE THERE THINGS THAT THE DA VINCI ROBOT CAN'T DO THAT A HUMAN CAN DO?

THE RELATIONSHIP BETWEEN THE SURGEON AND THE ROBOTIC ARMS IS THE MASTER/SLAVE RELATIONSHIP.

SO IT'S NOT THE ROBOT DOING THE SURGERY.

IT'S STILL THE SURGEON DOING THE SURGERY.

BUT IT'S THE TRANSLATION AND TRANSMISSION OF THE SURGEON'S MOVEMENTS TO THE ROBOT.

SO THE ADVANTAGE OF ROBOTIC SURGERY VERSUS CONVENTIONAL LAPAROSCOPIC OR VIDEOSCOPIC SURGERY IS IT'S LIKE WORKING WITH YOUR OWN HANDS AND VERSUS WORKING WITH CHOP STICKS.

THE ROBOTIC ARM CAN MOVE UP TO 6-8 DEGREES IN DIFFERENT WAYS SO YOU CAN BE DOING A MANEUVER WHICH IS COMPLETELY NOT POSSIBLE WITH YOUR OWN HAND BUT WITH THE ROBOT YOU CAN TWIST AND TURN-ONE BIG ADVANTAGE OF ROBOTIC SURGERY IS THAT IT GIVES YOU THE VISUALIZATION...NUMBER ONE IS HIGH-DEFINITION.

THE SYSTEMS WHICH ARE COMING OUT ARE HIGH-DEF.

SO YOU GET VERY CLEAR VISUALIZATION OF WHAT YOU'RE WORKING ON.

NUMBER 2 IT'S MAGNIFIED VIEW.

NUMBER 3 IT'S 3-DIMENSIONAL VIEW.

NOW WHAT ARE THE FUTURE APPLICATIONS OF SOME OF THIS?

WHAT DO YOU SEE ON THE HORIZON?

RIGHT NOW THE PROBLEMS ARE WITH LATENCY THAT THERE IS A DELAY IN TRANSMISSION OF INFORMATION.

ONCE THAT TECHNOLOGY IS THERE YOU CAN HAVE THE SURGEON SITTING IN WASHINGTON, DC AND THE PATIENT IN TOKYO, JAPAN.

AND THE SECOND AREA WHICH A LOT OF PEOPLE ARE VISUALIZING AND IMAGINING AT WHAT'S GOING TO HAPPEN IS ONCE THE TECHNOLOGY WITH IMAGING...THE 3-D CAT SCANNERS AND EVERYTHING BECOMES "STATE-OF-THE-ART" THEN WE WILL START TALKING ABOUT INCISION-LESS SURGERY WHERE YOU DON'T EVEN HAVE TO MAKE AN INCISION TO THE SURGERY THAT YOU'RE TALKING ABOUT.

IT'S MIND-BLOWING TO ME.

SOMEBODY WHO'S BEEN OUT OF SCHOOL FOR 30 YEARS OR SO.

LET ME ASK YOU ONE FINAL QUESTION.

WHAT KIND OF ADVICE WOULD YOU GIVE TO PATIENTS OUT THERE WHO ARE CONSIDERING HAVING THIS PROCEDURE DONE?

THE TECHNOLOGY IS STILL EVOLVING.

IT'S NOT THERE YET WHERE WE NEED IT TO BE BUT IT'S A GREAT TECHNOLOGY AND JUST ASK YOUR DOCTOR, SATISFY YOURSELF AND MAKE SURE THIS IS THE RIGHT THING FOR YOU.

GOOD.

DR. NAJAM THANKS FOR GIVING US LOTS OF HOPE ABOUT THE FUTURE.

THANK YOU SO MUCH.

WHEN HEALTHLINE RETURNS WE'LL RECAP SOME OF THE KEY ADVANTAGES OF ROBOTIC SURGERY.

COMING UP.

WELCOME BACK TO HEALTHLINE.

NEXT YEAR MORE THAN 100,000 ROBOTIC SURGERIES WILL BE PERFORMED IN THE U.S.

ROBOTIC ASSISTED SURGERIES FOR THE HEART AND PROSTATE ARE INCREASINGLY COMMON.

AND NEW PROCEDURES ARE UNDERWAY.

ROBOTIC SURGERY OFFERS A NUMBER OF POTENTIAL BENEFITS.

INCLUDING SMALLER INCISIONS.

WHICH MEANS OFTEN LESS SCARING AND TRAUMA.

AND ALSO LESS BLEEDING.

OTHER POTENTIAL BENEFITS CAN INCLUDE: REDUCED INFECTIONS AND SHORTER HOSPITAL STAYS.

FINALLY MANY PATIENTS EXPERIENCE A QUICKER RETURN TO THEIR NORMAL ACTIVITIES.

AND IN THE CASE OF PROSTATE SURGERY FULL CONTINENCE AND RETURN TO NORMAL SEXUAL FUNCTION.

SO BE YOUR OWN BEST ADVOCATE.

ASK YOUR DOCTOR ABOUT ALL YOUR OPTIONS AND WHAT ROBOTIC SURGERY MIGHT DO FOR YOU.

ALSO YOU CAN ALWAYS CONTACT HEALTHLINE AT THE RETIREMENT LIVING WEBSITE.

WWW.RL.TV.

OR CALL US AT 1-800-R-LIVING.

AND YOU CAN WRITE TO US AT HEALTHLINE P.O. BOX 7000, COLUMBIA, MARYLAND 21045.

THAT'S IT FOR THIS EDITION OF HEALTHLINE.

I'M DOCTOR KEVIN SODEN. THANKS FOR WATCHING.

UNTIL NEXT TIME HERE'S WISHING YOU THE BEST OF HEALTH.

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