January 27, 2012 / 2:31 AM / 7 years ago

Men's hopes for robot prostate surgery unrealistic:study

Jan 27 (Reuters) - Robot-assisted surgery for prostate cancer has become a hot topic in recent years, but men’s expectations of the surgery - including how fast they can return to their usual physical activity — may be too high, according to a U.S. study.

Researchers writing in the journal Urology found that of nearly 200 men facing prostate cancer surgery, those having robotic surgery expected a shorter hospital stay and a faster recovery, including a quicker return to their sex life.

The expectations are likely to be fed by ads, the Internet and counseling by doctors, said Judd W. Moul, a prostate surgeon at Duke University Medical Center who led the study.

“Since about the mid-2000s, people were thinking that robotic surgery was the greatest thing since sliced bread,” Moul said.

But according to previous studies, aside from a somewhat shorter hospital stay, there may be no clear difference in the most important outcomes, including cancer recurrence or long-term side effects.

Prostate removal is one treatment option for prostate cancer, and in the United States a majority of those surgeries are now done with the help of a “robot,” with a surgeon sitting at a console operating its “arms” that extract the prostate gland through small cuts in the abdomen.

Moul said there was reason to believe that better visualization with robotic surgery could lead to some better outcomes. But on the other hand, when surgeons actually use their hands they get “tactile feedback” that’s missing with the robotic approach.

In an earlier study, Moul and his colleagues found that men who had the robotic procedure were actually less satisfied in the long run than those who had traditional surgery, which they guessed had something to do with expectations.

So for the newest study, they surveyed 171 men about their expectations ahead of prostate cancer surgery. The majority of patients, 97, had opted for robotic surgery.

Overall, 89 percent of men having the robotic surgery expected to stay in the hospital just one night, versus 37 percent of men having traditional surgery.

The robotic surgery group thought they would be back to exercising sooner, typically predicting a five-week wait, against six weeks in the other group. They also expected to have recovered their erectile function within five months of surgery, while the other group thought it would take nine months.

Moul said that, on average, men having robotic surgery left hospital eight to 12 hours earlier, but that a small percentage did end up staying in the hospital a few days.

Asked to respond to the study, Intuitive Surgical, which makes the Da Vinci robotic surgery system, told Reuters Health that it did not comment on individual clinical trials.

Moul noted that surgeons do have an incentive to push men toward the new technology in order to hone their skills.

Increasingly, though, experts are saying that men should put more stock in their surgeon’s experience than on the type of surgery, and Moul agreed.

"Ask your surgeon the tough questions," such as how many procedures they've done, he said. SOURCE: bit.ly/zqY56u (Reporting from New York by Amy Norton at Reuters Health; editing by Elaine Lies and Jonathan Thatcher)

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