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Prominent Urologist Dr. David B. Samadi Presents Breakthrough Robotic Surgery Techniques on OR Live Webcast
Date:10/30/2008

r. Samadi can clearly see the neurovascular bundles and as a result, the nerves are kept entirely intact. Therefore, the visual accuracy gained during robotic surgery outweighs the benefits of tactile feedback normally associated with open prostate surgery.

There are, however, some high-risk prostate cancer patients, ones with Gleason 8 scores for instance, whose cavernous nerves should not be saved so that all cancerous tissue is removed. An endorectal MRI helps a surgeon decide whether it's best to spare the nerve, or not, in high-risk cases. Dr. David Samadi recommends an endorectal MRI for patients with high disease levels at apex, mid and base sections of the prostate. In describing the actual nerve sparing procedure in the OR-Live webcast, Dr. Samadi said, "I do most of the nerve sparing posteriorly, so when I take the pedicle, that plane is pretty much dissected and I reduce any risk of damage to the neurovascular bundle."

Another issue Dr. Samadi discussed during the webcast was the opening of the bladder neck. "I like to open the bladder neck early," said Samadi, who applies a principle from open surgery in this instance. "We learn from open surgery that you always go from known to unknown, so unlike many robotic surgeons, who work from lateral to medial and may be surprised by a big median lobe, I like to see exactly what the bladder neck looks like very early on so there won't be any surprises." Samadi emphasizes a fundamental belief to which he adheres. "I try to stay away from the lateral tissues as much as possible, because that's where you have most of your important structures during the surgery,"
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Prominent Urologist Dr. David B. Samadi Presents Breakthrough Robotic Surgery Techniques on OR Live Webcast
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