Drs. Savatta and Galdieri have been performing robotic surgery at Newark Beth Israel Medical Center since 2004. These clips are from surgeries at Newark Beth Israel Medical Center.
An overview of the technology and procedure can be found on a short video clip from Intuitive Surgical on their davinciprostatectomy.com site by clicking here.
Older video is archived below including nerve sparing robotic prostatectomy, a summary of a live kidney removal, and various prostate techniques that I developed.
In May of 2007 I performed the first live kidney removal with a robotic system. Our hospital helped edit the video and then placed it on youtube to my surprise. I will blog on this if you would like to add comments.
A new approach I have developed for accessing the bladder adn prostate. I have used this approach for bladder stones, BPH surgery, for large prostates during dvP, and also for complicated anatomy: I did one of these for a dvP after cryosurgery and another for a robotic prostatectomy that I performed after a failed prostatectomy by another surgeon.
A new technique I developed to help with large median lobes. I developed this technique in early 2007. I developed this by accident for prostate cancer while trying to find a better way to retract for robotic BPH surgery. I have seen other experts perform something similar with the 4th arm holding the prostate instead of suture. I think the suture holds better and gives better retraction.
As robotic prostatectomy has matured, the importance of cautery free technique has become more apparent. The gentler a surgeon is on the nerves to the penis, the quicker the patient recovers sexual function. The clip below demonstrates the one of the newest techniques, the Veil of Aphrodite.
Nerve sparing with veil of aphrodite technique (Summer 2006)- click picture for video
The preservation of urinary control depends on the preservation of the muscles very close to the prostate. These are located just beyond the tip of the prostate and in front of the tube that drains the urine from the bladder to the penis. Care needs to be taken while exposing the prostate, tying off the large veins between the urinary muscles and the prostate, removing the prostate, and sewing the bladder to the urethra. We prefer to perform these steps with minimal cautery to better preserve these structures.
The video clips for these steps of the operation can be seen by clicking below.
Exposing the prostate (Spring 2005)
Ligation of Dorsal Venous Complex (DVC) (Spring 2005)
Transecting the DVC and Urethra (Spring 2005)
Connecting the bladder to the urethra (Spring 2005)
The key part of the dvP that leads to the preservation of erections is sparing of the neurovascular bundle. At Associates in Urology, we use special Weck clips to control the blood supply and use only sharp dissection to spare the nerves.
Watch the nerve sparing part of the Davinci Robotic Prostatectomy (Spring 2005)
Updated 10/26/2007 byDomenico Savatta, M.D.