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Recently diagnosed...questions about robot-assisted surgery at Mayo
Hello, I was diagnosed with prostate cancer a couple months ago (age 69, Gleason 4+3, Decipher 0.69, PET-PSMA scan shows that cancer is currently localized to the prostate). I'm in good health otherwise.
Based on all the reading I have done, I am a good candidate for robot-assisted radical prostatectomy (RARP). I plan to meet with a surgeon at Mayo (Rochester, MN) about this. In the meantime, I was hoping to get some guidance here on the following:
1. Does Mayo routinely do real-time pathology during RARP (while the patient is still in the OR) to ensure that all the cancerous tissue is taken out? Or is it the surgeon's decision whether to do this? Can the patient request it?
2. Does the main surgeon at Mayo do the entire procedure or do fellows/residents also participate? If so, to what extent and is the main surgeon always in control?
3. If the surgery schedule of the surgeon I meet with is booked out several months, is there a way to transfer to another surgeon with a more open schedule without having to go through an initial consultation again (as it takes a while to set this up)? More generally, is there a way to get some visibility into surgery schedules ahead of time?
Thanks much!
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HugInterested in more discussions like this? Go to the Prostate Cancer Support Group.
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Their is more than one technique to RARP. Please review my post regarding Retzius sparing procedure. More often immediate continence or a couple days not months or a year of kegels. Also look into single port DaVinci versus Multi port. I explain these in my post. You can find them by clicking on my non face icon for my post. The real time pathology is important too. I believe Mayo does all this. Just inquire for the surgeons
@wheel1 @hopingtolearn
Here’s a link to the article you’re referring to.
https://connect.mayoclinic.org/comment/1548188/
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2 ReactionsHere's some information from Mayo Clinic on the topic:
- Mayo Clinic experience with da Vinci SP single-port robot-assisted radical prostatectomy (2019) https://www.mayoclinic.org/medical-professionals/urology/news/mayo-clinic-experience-with-da-vinci-sp-single-port-robot-assisted-radical-prostatectomy/mac-20455123
- Single-port robotics reduce incisions, may lead to less pain and quicker recovery from prostatectomy https://www.mayoclinic.org/medical-professionals/urology/news/single-port-robotics-reduce-incisions-may-lead-to-less-pain-and-quicker-recovery-from-prostatectomy/mqc-20528373
- Advancements in prostatectomy: Single-port robotic technique optimizes patient benefits (2024) https://www.mayoclinic.org/medical-professionals/cancer/news/advancements-in-prostatectomy-single-port-robotic-technique-optimizes-patient-benefits/mac-20562332
Thank you @wheel1 and @jeffmarc, so much useful information here. Will read through carefully and post back with any questions.
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1 ReactionI can answer about the fellow/residents. As a center of excellence, I have never been to Mayo when I was not seen by or shadowed by multiple residents. I did not have my RARP at Mayo but several other surgeries.
During my RARP at Mayo Jax, they did a real-time path report while I was still in OR. I never understood why they did that and never did ask. When I had the initial appointment with my surgeon, he shared with me his general surgery schedule (like "my next available is about mid-December..."). If you switch surgeons, you will need an appointment with him/her first before they agree to do your surgery (that's what I assume). Hope this helps some and best of luck!
Real time pathology allows them in surgery to ascertain if you have a positive margin or negative margin after the surgery. If positive instead of closing you up they can reinitiate surgery to try to further eliminate the positive margin so at your post surgical appointment you don’t hear sorry you have positive margin. The surgeon is also able to remove lymph nodes and confirm they are negative regardless that the PET showed that the cancer was supposedly contained in the capsule.