RE: Discussions on open verses robotic

[Guest guest]

I just want to say how much I value the calm, balanced and thoughtful contributions which Jon in Nevada and especially and Terry always make. When someone irritates me with a dubious comment, I try to wait to see what these guys say and it always reflects what I think but is put in a much more pleasant manner than I feel like offering at the time!

Keep up the good work - moderators in two senses!!

To: ProstateCancerSupport Sent: Wednesday, 26 August, 2009 11:09:26 AMSubject: Discussions on open verses robotic

It isn't often that I intervene these days, but here I'll reiterate the group maxim.

Don't jump into treatment before you are informed - make the decision yours in consultation with the ones who count in your life.

Some information comes from experience, others come from research projects, some comes from discussion with medics and fellow patients. At the end of the day it is down to personal choice, what is right for you and yours.

It perhaps doesn't mattter too much who invented what and when. It matters that people know what is looks most attractive for them based on what they have found out.

Terry and other experienced members try to flag up possible contrasts between word of mouth and research. Well worth taking into account.

If we listened to the best stories of any procedure, everyone whould use that one, equally if the worst stories of the same procedure were the only ones about no one would use it.

My take on robotic is that in the right hands it can provide a faster recovery period, with less blood loss and gives an expert a better view of the area to be worked on (as does laproscopic) . I think it takes a special surgeon to operate the kit and just maybe then might have the edge on the open surgery but.....

[Guest guest]

I just want to say how much I value the calm, balanced and thoughtful contributions which Jon in Nevada and especially and Terry always make. When someone irritates me with a dubious comment, I try to wait to see what these guys say and it always reflects what I think but is put in a much more pleasant manner than I feel like offering at the time!

Keep up the good work - moderators in two senses!!

To: ProstateCancerSupport Sent: Wednesday, 26 August, 2009 11:09:26 AMSubject: Discussions on open verses robotic

It isn't often that I intervene these days, but here I'll reiterate the group maxim.

Don't jump into treatment before you are informed - make the decision yours in consultation with the ones who count in your life.

Some information comes from experience, others come from research projects, some comes from discussion with medics and fellow patients. At the end of the day it is down to personal choice, what is right for you and yours.

It perhaps doesn't mattter too much who invented what and when. It matters that people know what is looks most attractive for them based on what they have found out.

Terry and other experienced members try to flag up possible contrasts between word of mouth and research. Well worth taking into account.

If we listened to the best stories of any procedure, everyone whould use that one, equally if the worst stories of the same procedure were the only ones about no one would use it.

My take on robotic is that in the right hands it can provide a faster recovery period, with less blood loss and gives an expert a better view of the area to be worked on (as does laproscopic) . I think it takes a special surgeon to operate the kit and just maybe then might have the edge on the open surgery but.....

[Guest guest]

I just want to say how much I value the calm, balanced and thoughtful contributions which Jon in Nevada and especially and Terry always make. When someone irritates me with a dubious comment, I try to wait to see what these guys say and it always reflects what I think but is put in a much more pleasant manner than I feel like offering at the time!

Keep up the good work - moderators in two senses!!

To: ProstateCancerSupport Sent: Wednesday, 26 August, 2009 11:09:26 AMSubject: Discussions on open verses robotic

It isn't often that I intervene these days, but here I'll reiterate the group maxim.

Don't jump into treatment before you are informed - make the decision yours in consultation with the ones who count in your life.

Some information comes from experience, others come from research projects, some comes from discussion with medics and fellow patients. At the end of the day it is down to personal choice, what is right for you and yours.

It perhaps doesn't mattter too much who invented what and when. It matters that people know what is looks most attractive for them based on what they have found out.

Terry and other experienced members try to flag up possible contrasts between word of mouth and research. Well worth taking into account.

If we listened to the best stories of any procedure, everyone whould use that one, equally if the worst stories of the same procedure were the only ones about no one would use it.

My take on robotic is that in the right hands it can provide a faster recovery period, with less blood loss and gives an expert a better view of the area to be worked on (as does laproscopic) . I think it takes a special surgeon to operate the kit and just maybe then might have the edge on the open surgery but.....

[Guest guest]

I've read dozens of reports from people who are very pleased with their robotic surgery procedure.

Can anyone recall posters who have had robotic surgery who were unhappy with the outcome and wished they had gone the "open" route?

To: ProstateCancerSupport Sent: Wednesday, August 26, 2009 1:29:26 PMSubject: Re: Discussions on open verses robotic

I just want to say how much I value the calm, balanced and thoughtful contributions which Jon in Nevada and especially and Terry always make. When someone irritates me with a dubious comment, I try to wait to see what these guys say and it always reflects what I think but is put in a much more pleasant manner than I feel like offering at the time!

Keep up the good work - moderators in two senses!!

From: Metcalf <bryan.metcalf@ virgin.net>To: ProstateCancerSuppo rtyahoogroups (DOT) comSent: Wednesday, 26 August, 2009 11:09:26 AMSubject: [ProstateCancerSupp ort] Discussions on open verses robotic

It isn't often that I intervene these days, but here I'll reiterate the group maxim.

Don't jump into treatment before you are informed - make the decision yours in consultation with the ones who count in your life.

Some information comes from experience, others come from research projects, some comes from discussion with medics and fellow patients. At the end of the day it is down to personal choice, what is right for you and yours.

It perhaps doesn't mattter too much who invented what and when. It matters that people know what is looks most attractive for them based on what they have found out.

Terry and other experienced members try to flag up possible contrasts between word of mouth and research. Well worth taking into account.

If we listened to the best stories of any procedure, everyone whould use that one, equally if the worst stories of the same procedure were the only ones about no one would use it.

My take on robotic is that in the right hands it can provide a faster recovery period, with less blood loss and gives an expert a better view of the area to be worked on (as does laproscopic) . I think it takes a special surgeon to operate the kit and just maybe then might have the edge on the open surgery but.....

[Guest guest]

Yes, I can recall dissatisfaction after

reading more than one thousand stories from men who have been diagnosed with

PCa. There are men who have had very bad outcomes after RALP (Robotic Assisted

Laparoscopic Prostatectomy) including one man who was totally incontinent and

impotent. There are others with less dramatic outcomes – and many good

ones, as there are with the normal open prostatectomy.

Most men realize that, having made their

decision there is no turning back the clock, so very few express ‘second

guessing’, but, having said that, only yesterday there was a post on

another forum saying in part <snip> I tend to think that both you and I

would of been better off without the robot...so a good old fashioned surgeon

with a knife could cut and feel things with their hands and realize that cancer

has broke through a margin ….. <snip>

All the best

Terry Herbert

I have no medical

qualifications but I was diagnosed in ‘96: and have learned a bit since

then.

My sites are at www.yananow.net and www.prostatecancerwatchfulwaiting.co.za

Dr

“Snuffy” Myers : " As a physician, I am painfully aware that most of

the decisions we make with regard to prostate cancer are made with inadequate

data "

From: ProstateCancerSupport [mailto:ProstateCancerSupport ] On Behalf Of B Pender

Sent: Thursday, 27 August 2009

7:00 AM

To: ProstateCancerSupport

Subject: Re:

Discussions on open verses robotic

I've read dozens of reports from people who are very pleased

with their robotic surgery procedure.

Can anyone recall posters who have had

robotic surgery who were unhappy with the outcome and wished they had gone

the " open " route?

From: DAVID COLLINS

<sirenettabtinternet>

To: ProstateCancerSupport

Sent: Wednesday, August 26, 2009

1:29:26 PM

Subject: Re:

Discussions on open verses robotic

I just want to say how much I value the calm, balanced and thoughtful

contributions which Jon in Nevada

and especially and Terry always make. When someone irritates me

with a dubious comment, I try to wait to see what these guys say and it always

reflects what I think but is put in a much more pleasant manner than I feel

like offering at the time!

Keep up the good work - moderators in two senses!!

From: Metcalf

<bryan.metcalf@ virgin.net>

To: ProstateCancerSuppo

rtyahoogroups (DOT) com

Sent: Wednesday, 26 August, 2009

11:09:26 AM

Subject: [ProstateCancerSupp ort]

Discussions on open verses robotic

It isn't often that I intervene these days, but here I'll reiterate the

group maxim.

Don't jump into treatment before you are informed - make the decision

yours in consultation with the ones who count in your life.

Some information comes from experience, others come from research

projects, some comes from discussion with medics and fellow patients. At the

end of the day it is down to personal choice, what is right for you and yours.

It perhaps doesn't mattter too much who invented what and when. It

matters that people know what is looks most attractive for them based on what

they have found out.

Terry and other experienced members try to flag up possible contrasts

between word of mouth and research. Well worth taking into account.

If we listened to the best stories of any procedure, everyone whould

use that one, equally if the worst stories of the same procedure were the only

ones about no one would use it.

My take on robotic is that in the right hands it can provide

a faster recovery period, with less blood loss and gives an expert a

better view of the area to be worked on (as does laproscopic) . I think it

takes a special surgeon to operate the kit and just maybe then might have the

edge on the open surgery but.....

[Guest guest]

> I've read dozens of reports from people who are very pleased

> with their robotic surgery procedure.

>

> Can anyone recall posters who have had robotic surgery who

> were unhappy with the outcome and wished they had gone the

> " open " route?

If and when the outcome is bad after a medical procedure it's

usually impossible to know why.

Was it robotic vs. open surgery?

Was it the wrong surgeon?

Was it the wrong treatment choice (surgery vs. radiation?)

Was the surgeon having a bad day?

Was my particular physiology, or the configuration of my

prostate or my tumors the cause?

Was it just bad luck?

If things go wrong (incontinence, impotence, pain, cancer

recurrence) how can anyone tell what caused the problem?

Alan

[Guest guest]

> I've read dozens of reports from people who are very pleased

> with their robotic surgery procedure.

>

> Can anyone recall posters who have had robotic surgery who

> were unhappy with the outcome and wished they had gone the

> " open " route?

If and when the outcome is bad after a medical procedure it's

usually impossible to know why.

Was it robotic vs. open surgery?

Was it the wrong surgeon?

Was it the wrong treatment choice (surgery vs. radiation?)

Was the surgeon having a bad day?

Was my particular physiology, or the configuration of my

prostate or my tumors the cause?

Was it just bad luck?

If things go wrong (incontinence, impotence, pain, cancer

recurrence) how can anyone tell what caused the problem?

Alan

[Guest guest]

Alan,

I had robotic surgery at s Hopkins 7/06.

While initial recovery was easy, I leaked profusely from the start... around the catheter in the hospital.

And in excess of a quart per day post catheter. ED from the start as well. Two AdVance slings installed since. Next step will be artifical sphincter.

Why this degree of negative side-effects? I do not know. Surgeon told me that he was unable to spare nerves on one side, and he took some nerves on other side to ensure that he had adequate margins. I conclude that my body configuration and the nature of the cancer is the root cause of this.

Surgeon is no longer at Hopkins. Do not know why.

Bi-Mix helps with ED. VED helps with peyronies. as does traction.

If I were re-doing this, I would have had traditional open surgery.

In my judgment, the surgeons over-promised, and under delivered.

Bottom Line, psa <0.1. That's first and foremost. However, the guys I know that have had traditional surgery have had a far better outcome.

All my buddies have dealt with varying degrees of ED, but none have lived with diapers and the requirement to change 3-5 times per day.

I do no regret surgery over radiation. For my situation, I do not think radiation was the optimal option.

Hope this helps.

Hans

To: ProstateCancerSupport Sent: Wednesday, August 26, 2009 6:52:56 PMSubject: Re: Discussions on open verses robotic

On Wed, 8/26/09, B Pender <b2p16yahoo (DOT) com> wrote:> I've read dozens of reports from people who are very pleased> with their robotic surgery procedure.> > Can anyone recall posters who have had robotic surgery who> were unhappy with the outcome and wished they had gone the> "open" route?If and when the outcome is bad after a medical procedure it'susually impossible to know why.Was it robotic vs. open surgery?Was it the wrong surgeon?Was it the wrong treatment choice (surgery vs. radiation?)Was the surgeon having a bad day?Was my particular physiology, or the configuration of myprostate or my tumors the cause?Was it just bad luck?If things go wrong (incontinence, impotence, pain, cancerrecurrence) how can anyone tell what

caused the problem?Alan

[Guest guest]

Alan,

I had robotic surgery at s Hopkins 7/06.

While initial recovery was easy, I leaked profusely from the start... around the catheter in the hospital.

And in excess of a quart per day post catheter. ED from the start as well. Two AdVance slings installed since. Next step will be artifical sphincter.

Why this degree of negative side-effects? I do not know. Surgeon told me that he was unable to spare nerves on one side, and he took some nerves on other side to ensure that he had adequate margins. I conclude that my body configuration and the nature of the cancer is the root cause of this.

Surgeon is no longer at Hopkins. Do not know why.

Bi-Mix helps with ED. VED helps with peyronies. as does traction.

If I were re-doing this, I would have had traditional open surgery.

In my judgment, the surgeons over-promised, and under delivered.

Bottom Line, psa <0.1. That's first and foremost. However, the guys I know that have had traditional surgery have had a far better outcome.

All my buddies have dealt with varying degrees of ED, but none have lived with diapers and the requirement to change 3-5 times per day.

I do no regret surgery over radiation. For my situation, I do not think radiation was the optimal option.

Hope this helps.

Hans

To: ProstateCancerSupport Sent: Wednesday, August 26, 2009 6:52:56 PMSubject: Re: Discussions on open verses robotic

On Wed, 8/26/09, B Pender <b2p16yahoo (DOT) com> wrote:> I've read dozens of reports from people who are very pleased> with their robotic surgery procedure.> > Can anyone recall posters who have had robotic surgery who> were unhappy with the outcome and wished they had gone the> "open" route?If and when the outcome is bad after a medical procedure it'susually impossible to know why.Was it robotic vs. open surgery?Was it the wrong surgeon?Was it the wrong treatment choice (surgery vs. radiation?)Was the surgeon having a bad day?Was my particular physiology, or the configuration of myprostate or my tumors the cause?Was it just bad luck?If things go wrong (incontinence, impotence, pain, cancerrecurrence) how can anyone tell what

caused the problem?Alan

[Guest guest]

>

> > I've read dozens of reports from people who are very pleased

> > with their robotic surgery procedure.

> >

> > Can anyone recall posters who have had robotic surgery who

> > were unhappy with the outcome and wished they had gone the

> > " open " route?

>

> If and when the outcome is bad after a medical procedure it's

> usually impossible to know why.

>

> Was it robotic vs. open surgery?

>

> Was it the wrong surgeon?

>

> Was it the wrong treatment choice (surgery vs. radiation?)

Dear Alan, could you please tell me how much Vit E you were taking that helped

the Peyronnies disease. My husband is taking Vit E, but just once a day. Should

he be taking more?

Thank you for you time. Have a great day.

Best Wishes,

Sheila

>

> Was the surgeon having a bad day?

>

> Was my particular physiology, or the configuration of my

> prostate or my tumors the cause?

>

> Was it just bad luck?

>

> If things go wrong (incontinence, impotence, pain, cancer

> recurrence) how can anyone tell what caused the problem?

>

> Alan

>

[Guest guest]

>

> > I've read dozens of reports from people who are very pleased

> > with their robotic surgery procedure.

> >

> > Can anyone recall posters who have had robotic surgery who

> > were unhappy with the outcome and wished they had gone the

> > " open " route?

>

> If and when the outcome is bad after a medical procedure it's

> usually impossible to know why.

>

> Was it robotic vs. open surgery?

>

> Was it the wrong surgeon?

>

> Was it the wrong treatment choice (surgery vs. radiation?)

Dear Alan, could you please tell me how much Vit E you were taking that helped

the Peyronnies disease. My husband is taking Vit E, but just once a day. Should

he be taking more?

Thank you for you time. Have a great day.

Best Wishes,

Sheila

>

> Was the surgeon having a bad day?

>

> Was my particular physiology, or the configuration of my

> prostate or my tumors the cause?

>

> Was it just bad luck?

>

> If things go wrong (incontinence, impotence, pain, cancer

> recurrence) how can anyone tell what caused the problem?

>

> Alan

>

[Guest guest]

What I did, and I'd recommend for anyone, before surgery reading everything I

could find and looking for post surgery reports of side effects and

complications. Obviously the recovery was more drawn out with the open surgery,

but back in 06 when I had mine, the robotic surgery seemed to give quite a bit

more incontinence and ED issues. Here on the internet we do get more negative

posts since people are more apt to complain when things go wrong, but that type

of info is what we're after in this case. I suppose the techniques and surgeon's

experience are somewhat better at this point with the robotic procedure so past

results are not all that helpful in deciding.

[Guest guest]

What I did, and I'd recommend for anyone, before surgery reading everything I

could find and looking for post surgery reports of side effects and

complications. Obviously the recovery was more drawn out with the open surgery,

but back in 06 when I had mine, the robotic surgery seemed to give quite a bit

more incontinence and ED issues. Here on the internet we do get more negative

posts since people are more apt to complain when things go wrong, but that type

of info is what we're after in this case. I suppose the techniques and surgeon's

experience are somewhat better at this point with the robotic procedure so past

results are not all that helpful in deciding.

[Guest guest]

There is another surgical option, rather old-fashioned, the perineal approach (behind the rectum), that has recovery time comparable to robotic surgery, and significantly low incidence of urinary problems than the either R/P methods. Some surgeons claim that nerve sparing is harder than with the R/P access, but in any case, aggressive penile rehab early after surgery is important. Louis. . . . To: ProstateCancerSupport Sent: Thursday, August 27, 2009 8:16:53 AMSubject: Re: Discussions on open verses robotic

Alan,

I had robotic surgery at s Hopkins 7/06.

While initial recovery was easy, I leaked profusely from the start... around the catheter in the hospital.

And in excess of a quart per day post catheter. ED from the start as well. Two AdVance slings installed since. Next step will be artifical sphincter.

Why this degree of negative side-effects? I do not know. Surgeon told me that he was unable to spare nerves on one side, and he took some nerves on other side to ensure that he had adequate margins. I conclude that my body configuration and the nature of the cancer is the root cause of this.

Surgeon is no longer at Hopkins. Do not know why.

Bi-Mix helps with ED. VED helps with peyronies. as does traction.

If I were re-doing this, I would have had traditional open surgery.

In my judgment, the surgeons over-promised, and under delivered.

Bottom Line, psa <0.1. That's first and foremost. However, the guys I know that have had traditional surgery have had a far better outcome.

All my buddies have dealt with varying degrees of ED, but none have lived with diapers and the requirement to change 3-5 times per day.

I do no regret surgery over radiation. For my situation, I do not think radiation was the optimal option.

Hope this helps.

Hans

From: Alan Meyer <ameyer2yahoo (DOT) com>To: ProstateCancerSuppo rtyahoogroups (DOT) comSent: Wednesday, August 26, 2009 6:52:56 PMSubject: Re: [ProstateCancerSupp ort] Discussions on open verses robotic

On Wed, 8/26/09, B Pender <b2p16yahoo (DOT) com> wrote:> I've read dozens of reports from people who are very pleased> with their robotic surgery procedure.> > Can anyone recall posters who have had robotic surgery who> were unhappy with the outcome and wished they had gone the> "open" route?If and when the outcome is bad after a medical procedure it'susually impossible to know why.Was it robotic vs. open surgery?Was it the wrong surgeon?Was it the wrong treatment choice (surgery vs. radiation?)Was the surgeon having a bad day?Was my particular physiology, or the configuration of myprostate or my tumors the cause?Was it just bad luck?If things go wrong (incontinence, impotence, pain, cancerrecurrence) how can anyone tell what

caused the problem?Alan

[Guest guest]

There is another surgical option, rather old-fashioned, the perineal approach (behind the rectum), that has recovery time comparable to robotic surgery, and significantly low incidence of urinary problems than the either R/P methods. Some surgeons claim that nerve sparing is harder than with the R/P access, but in any case, aggressive penile rehab early after surgery is important. Louis. . . . To: ProstateCancerSupport Sent: Thursday, August 27, 2009 8:16:53 AMSubject: Re: Discussions on open verses robotic

Alan,

I had robotic surgery at s Hopkins 7/06.

While initial recovery was easy, I leaked profusely from the start... around the catheter in the hospital.

And in excess of a quart per day post catheter. ED from the start as well. Two AdVance slings installed since. Next step will be artifical sphincter.

Why this degree of negative side-effects? I do not know. Surgeon told me that he was unable to spare nerves on one side, and he took some nerves on other side to ensure that he had adequate margins. I conclude that my body configuration and the nature of the cancer is the root cause of this.

Surgeon is no longer at Hopkins. Do not know why.

Bi-Mix helps with ED. VED helps with peyronies. as does traction.

If I were re-doing this, I would have had traditional open surgery.

In my judgment, the surgeons over-promised, and under delivered.

Bottom Line, psa <0.1. That's first and foremost. However, the guys I know that have had traditional surgery have had a far better outcome.

All my buddies have dealt with varying degrees of ED, but none have lived with diapers and the requirement to change 3-5 times per day.

I do no regret surgery over radiation. For my situation, I do not think radiation was the optimal option.

Hope this helps.

Hans

From: Alan Meyer <ameyer2yahoo (DOT) com>To: ProstateCancerSuppo rtyahoogroups (DOT) comSent: Wednesday, August 26, 2009 6:52:56 PMSubject: Re: [ProstateCancerSupp ort] Discussions on open verses robotic

On Wed, 8/26/09, B Pender <b2p16yahoo (DOT) com> wrote:> I've read dozens of reports from people who are very pleased> with their robotic surgery procedure.> > Can anyone recall posters who have had robotic surgery who> were unhappy with the outcome and wished they had gone the> "open" route?If and when the outcome is bad after a medical procedure it'susually impossible to know why.Was it robotic vs. open surgery?Was it the wrong surgeon?Was it the wrong treatment choice (surgery vs. radiation?)Was the surgeon having a bad day?Was my particular physiology, or the configuration of myprostate or my tumors the cause?Was it just bad luck?If things go wrong (incontinence, impotence, pain, cancerrecurrence) how can anyone tell what

caused the problem?Alan

[Guest guest]

Alan makes some very good points. ED can be hard on a man's psyche.

It has been 3 years since I had a robotic assisted laproscopic radical

prostatectomy. I am now 46 years old & in good shape. I lift weights & bicycle

regularly. After my surgery the incontinence was modest but slowly diminished

over 3 months. I'm now dry with a rare " 3 drops ooops " .

Erections were another matter. My surgery was dual nerve sparing. So my

expectations were high. It was 3 months before I started having modest

erections. Around 6 months I experienced a step change in quality. At this time

I was using pills (viagra, etc.) but still had variable results. With time,

practice, and a caring/understanding partner I worked through it all. I no

longer use pills & have no ED problems. My doctor said at 18 months I would know

where things would end up. I was at 30 months & still noticing small quality

improvements. I've noticed no change in the last 6 months.

The thing I want to share is that along the way I realized the ED problems were

in my head. I had seen an erection with no pills/help. So the " wiring " was

functional. It was the fears & doubts in my head which were conspiring against

success. Once I made that connection I was able to rebuild my confidence. With

confidence came success. (This brings to mind a saying I once read: the mind is

the largest sex organ.) I believe this is a point which does not get enough

emphasis in the recovery phase.

All in all I feel like I am back to where I was before the surgery. My PSA is

undetectable. My quality of life is undiminished. If I had to do it over again

I'd take the same path.

[Guest guest]

As I write this, I am awaiting the results of a PSA test from a sample drawn last week.

Two years ago this month I had a robotic laparoscopic RP at Northwestern University Medical Center in Chicago. The surgeon who performed the surgery had performed about 300 such procedures per year for a few years prior to accepting me as a patient. I say "accepting" because he and Northwestern track surgical outcomes for 5 years and I am convinced that they will reject cases that are predicted to have poor outcomes in order to elevate their statistical performance. My suburban urologist who performed my biopsy said as much when he advised, "IF they take you downtown, you will do great. They only take good patients. I get stuck doing the 70 year old obese patients with diabetes." I know one can read a lot into that comment and I will leave you to your interpretations, but I agree with the sentiment that a major med center with a well recognized specialty program is, shall we say,

conscious, of their results.

Anyhow, I had the surgery and, although I was in the OR for 6 hours, was released from the hospital to return home the day following the procedure. Catheter for 10 days. When the catheter came out I was prepared with a box of adult diapers (48 count) and heavy duty pads. I used a couple of the diapers and then wore a pad for a few days while at work just in case I had an accident. I didn't. Within a few weeks of the surgery I had zero leakage and disregarded incontinence as an issue.

I did go on a Muse/Cialis/Viagra rehab program with little results for the first several months. My surgery was full nerve sparing and I believe my surgeon prolonged the surgery (remember, it was six hours long) in a very dedicated effort to minimize disruption/damage to nerve and vascular bundles that he and I discussed at length before the surgery.

By the one year mark I was recovering function rather well but was not completely satisfied. I made an appointment to see Jeff Albough, ED specialist at Northwestern, in month 13 following surgery. Due to schedule problems, I was unable to see him until month 16. My intent was to get right into injections, but by month 16 I was doing very well with Cialis/Viagra (has anyone EVER benefitted from Muse?) and getting stronger and stronger without any meds. Jeff urged me to be a little more patient and not change anything I was doing. I followed his advice and by month 18 I was using meds more for recreational use than necessity. Today, at 24 months, I can take them or leave them.

Through it all, my PSA post surgery has vacillated between 0.0 and 0.1 which I believe is statistically the same. I have no reason to believe my test taken last week will be any different.

In sum, I am very pleased with my choice of surgeons, medical center and procedure based on the outcomes. At Northwestern's invitation I have joined their list of reference patients who are available to talk to prospective patients about the process and program at Northwestern. When I receive a call at home from someone who is where I was two years ago, I am very careful to point out the "Your Mileage May Vary" considerations but, if I had it to do over, I would not change a thing. Could the outcome have been the same with open RP? I am certain it could have been but not at all certain that it would have been.

I do agree with another poster who pointed out that these forums tend to be overpopulated with cancer patients who are seeking input to assist them with their decision making or are having problems and are seeking direction. It is unfortunate because it may give the impression to newly diagnosed readers that there are no patients with satisfactory results. It would be great if people who went through the process and recovered very nicely remained in touch with the forums but that is not the way of the world. As time passes I find myself viewing my summer of 2007 "ordeal" as no more or less eventful than an appendectomy I had in "84. Yep it happened and now it's behind me.

Best regards to all.

Subject: Discussions on open verses roboticTo: ProstateCancerSupport Date: Wednesday, August 26, 2009, 6:09 AM

It isn't often that I intervene these days, but here I'll reiterate the group maxim.

Don't jump into treatment before you are informed - make the decision yours in consultation with the ones who count in your life.

Some information comes from experience, others come from research projects, some comes from discussion with medics and fellow patients. At the end of the day it is down to personal choice, what is right for you and yours.

It perhaps doesn't mattter too much who invented what and when. It matters that people know what is looks most attractive for them based on what they have found out.

Terry and other experienced members try to flag up possible contrasts between word of mouth and research. Well worth taking into account.

If we listened to the best stories of any procedure, everyone whould use that one, equally if the worst stories of the same procedure were the only ones about no one would use it.

My take on robotic is that in the right hands it can provide a faster recovery period, with less blood loss and gives an expert a better view of the area to be worked on (as does laproscopic) . I think it takes a special surgeon to operate the kit and just maybe then might have the edge on the open surgery but....

[Guest guest]

As I write this, I am awaiting the results of a PSA test from a sample drawn last week.

Two years ago this month I had a robotic laparoscopic RP at Northwestern University Medical Center in Chicago. The surgeon who performed the surgery had performed about 300 such procedures per year for a few years prior to accepting me as a patient. I say "accepting" because he and Northwestern track surgical outcomes for 5 years and I am convinced that they will reject cases that are predicted to have poor outcomes in order to elevate their statistical performance. My suburban urologist who performed my biopsy said as much when he advised, "IF they take you downtown, you will do great. They only take good patients. I get stuck doing the 70 year old obese patients with diabetes." I know one can read a lot into that comment and I will leave you to your interpretations, but I agree with the sentiment that a major med center with a well recognized specialty program is, shall we say,

conscious, of their results.

Anyhow, I had the surgery and, although I was in the OR for 6 hours, was released from the hospital to return home the day following the procedure. Catheter for 10 days. When the catheter came out I was prepared with a box of adult diapers (48 count) and heavy duty pads. I used a couple of the diapers and then wore a pad for a few days while at work just in case I had an accident. I didn't. Within a few weeks of the surgery I had zero leakage and disregarded incontinence as an issue.

I did go on a Muse/Cialis/Viagra rehab program with little results for the first several months. My surgery was full nerve sparing and I believe my surgeon prolonged the surgery (remember, it was six hours long) in a very dedicated effort to minimize disruption/damage to nerve and vascular bundles that he and I discussed at length before the surgery.

By the one year mark I was recovering function rather well but was not completely satisfied. I made an appointment to see Jeff Albough, ED specialist at Northwestern, in month 13 following surgery. Due to schedule problems, I was unable to see him until month 16. My intent was to get right into injections, but by month 16 I was doing very well with Cialis/Viagra (has anyone EVER benefitted from Muse?) and getting stronger and stronger without any meds. Jeff urged me to be a little more patient and not change anything I was doing. I followed his advice and by month 18 I was using meds more for recreational use than necessity. Today, at 24 months, I can take them or leave them.

Through it all, my PSA post surgery has vacillated between 0.0 and 0.1 which I believe is statistically the same. I have no reason to believe my test taken last week will be any different.

In sum, I am very pleased with my choice of surgeons, medical center and procedure based on the outcomes. At Northwestern's invitation I have joined their list of reference patients who are available to talk to prospective patients about the process and program at Northwestern. When I receive a call at home from someone who is where I was two years ago, I am very careful to point out the "Your Mileage May Vary" considerations but, if I had it to do over, I would not change a thing. Could the outcome have been the same with open RP? I am certain it could have been but not at all certain that it would have been.

I do agree with another poster who pointed out that these forums tend to be overpopulated with cancer patients who are seeking input to assist them with their decision making or are having problems and are seeking direction. It is unfortunate because it may give the impression to newly diagnosed readers that there are no patients with satisfactory results. It would be great if people who went through the process and recovered very nicely remained in touch with the forums but that is not the way of the world. As time passes I find myself viewing my summer of 2007 "ordeal" as no more or less eventful than an appendectomy I had in "84. Yep it happened and now it's behind me.

Best regards to all.

Subject: Discussions on open verses roboticTo: ProstateCancerSupport Date: Wednesday, August 26, 2009, 6:09 AM

It isn't often that I intervene these days, but here I'll reiterate the group maxim.

Don't jump into treatment before you are informed - make the decision yours in consultation with the ones who count in your life.

Some information comes from experience, others come from research projects, some comes from discussion with medics and fellow patients. At the end of the day it is down to personal choice, what is right for you and yours.

It perhaps doesn't mattter too much who invented what and when. It matters that people know what is looks most attractive for them based on what they have found out.

Terry and other experienced members try to flag up possible contrasts between word of mouth and research. Well worth taking into account.

If we listened to the best stories of any procedure, everyone whould use that one, equally if the worst stories of the same procedure were the only ones about no one would use it.

My take on robotic is that in the right hands it can provide a faster recovery period, with less blood loss and gives an expert a better view of the area to be worked on (as does laproscopic) . I think it takes a special surgeon to operate the kit and just maybe then might have the edge on the open surgery but....

[Guest guest]

, I had the identical results as you following my procedure. My only concern is loss of size and girth of the penis. How do I regain any of the size? I get erections firm enough without meds or any thing...its the reduction that bothers me.

Anyone have suggestions to help?

From: Metcalf <bryan.metcalf@ virgin.net>Subject: [ProstateCancerSupp ort] Discussions on open verses roboticTo: ProstateCancerSuppo rtyahoogroups (DOT) comDate: Wednesday, August 26, 2009, 6:09 AM

It isn't often that I intervene these days, but here I'll reiterate the group maxim.

Don't jump into treatment before you are informed - make the decision yours in consultation with the ones who count in your life.

Some information comes from experience, others come from research projects, some comes from discussion with medics and fellow patients. At the end of the day it is down to personal choice, what is right for you and yours.

It perhaps doesn't mattter too much who invented what and when. It matters that people know what is looks most attractive for them based on what they have found out.

Terry and other experienced members try to flag up possible contrasts between word of mouth and research. Well worth taking into account.

If we listened to the best stories of any procedure, everyone whould use that one, equally if the worst stories of the same procedure were the only ones about no one would use it.

My take on robotic is that in the right hands it can provide a faster recovery period, with less blood loss and gives an expert a better view of the area to be worked on (as does laproscopic) . I think it takes a special surgeon to operate the kit and just maybe then might have the edge on the open surgery but....

[Guest guest]

, I had the identical results as you following my procedure. My only concern is loss of size and girth of the penis. How do I regain any of the size? I get erections firm enough without meds or any thing...its the reduction that bothers me.

Anyone have suggestions to help?

From: Metcalf <bryan.metcalf@ virgin.net>Subject: [ProstateCancerSupp ort] Discussions on open verses roboticTo: ProstateCancerSuppo rtyahoogroups (DOT) comDate: Wednesday, August 26, 2009, 6:09 AM

It isn't often that I intervene these days, but here I'll reiterate the group maxim.

Don't jump into treatment before you are informed - make the decision yours in consultation with the ones who count in your life.

Some information comes from experience, others come from research projects, some comes from discussion with medics and fellow patients. At the end of the day it is down to personal choice, what is right for you and yours.

It perhaps doesn't mattter too much who invented what and when. It matters that people know what is looks most attractive for them based on what they have found out.

Terry and other experienced members try to flag up possible contrasts between word of mouth and research. Well worth taking into account.

If we listened to the best stories of any procedure, everyone whould use that one, equally if the worst stories of the same procedure were the only ones about no one would use it.

My take on robotic is that in the right hands it can provide a faster recovery period, with less blood loss and gives an expert a better view of the area to be worked on (as does laproscopic) . I think it takes a special surgeon to operate the kit and just maybe then might have the edge on the open surgery but....

[Guest guest]

:

From a " neighbor " in the Chicago 'burbs,

congratulations and continued good health. Your essay was a breath of fresh air

and opens up a line of dialogue to which I have not been exposed or at least

participated. Apparently I'm one of those patients who's gone to the docs who

treat the obese 70 year olds with diabetes in the 'burbs. I want to be

quick to point out that the substandard treatment I've received has been from

urologists only. I am starting today with an IMRT course of treatment from a radiological

oncologist who seems to be on top of his game, and, I pray, is. The urologists

, on the other hand, have been significantly less than professional. I've

ticked off enough of my sad story on these pages and choose not to bore the

reader again, but, from a botched TUMT to a blatant effort to insist that my

treatment options have been misguided and everything in between, I've

received some truly awful care.

So, the question is, is there that much difference between the

quality of care in the 'burbs (I'm in the Fox Valley, but it could be 25 miles

out in any big city) and what one would receive at a large teaching hospital in

the city? I'm sure I'd expect some differences, but does that justify having to

drive 50-60 miles round trip in brutal traffic every day for the next 8 weeks? I've

started on my path to cancer-free existence, but I raise the question on behalf

of those who haven't and may be sitting 25 or 30 miles from downtown somewhere

and wondering whether to stay local or go into the city. Perhaps I sound naive,

but is the bar set that much higher at a Northwestern, Illinois or U.C.? It

might be illustrative to those who haven't chosen a " final step " or

even those who've just been diagnosed to kick this question around.

Tom Lauterback

From:

ProstateCancerSupport

[mailto:ProstateCancerSupport ] On Behalf Of Carroll

Sent: Monday, August 31, 2009 8:16 AM

To: ProstateCancerSupport

Subject: Re: Discussions on open verses robotic

As I write this, I am awaiting the results of a PSA test

from a sample drawn last week.

Two years ago this month I had a robotic

laparoscopic RP at Northwestern University Medical Center in Chicago. The

surgeon who performed the surgery had performed about 300 such procedures per

year for a few years prior to accepting me as a patient. I say

" accepting " because he and Northwestern track surgical outcomes for

5 years and I am convinced that they will reject cases that are predicted to

have poor outcomes in order to elevate their statistical performance.

My suburban urologist who performed my biopsy said as much when he advised,

" IF they take you downtown, you will do

great. They only take good patients. I get stuck doing the 70

year old obese patients with diabetes. " I know one can read a lot

into that comment and I will leave you to your interpretations, but I agree

with the sentiment that a major med center with a well recognized specialty

program is, shall we say, conscious, of their results.

Anyhow, I had the surgery and, although I was in the OR

for 6 hours, was released from the hospital to return home the day

following the procedure. Catheter for 10 days. When the catheter

came out I was prepared with a box of adult diapers (48 count) and heavy duty

pads. I used a couple of the diapers and then wore a pad for a few days

while at work just in case I had an accident. I didn't. Within a

few weeks of the surgery I had zero leakage and disregarded incontinence as

an issue.

I did go on a Muse/Cialis/Viagra rehab program with little

results for the first several months. My surgery was full nerve sparing

and I believe my surgeon prolonged the surgery (remember, it was six hours

long) in a very dedicated effort to minimize disruption/damage to nerve and

vascular bundles that he and I discussed at length before the surgery.

By the one year mark I was recovering function rather well

but was not completely satisfied. I made an appointment to see Jeff

Albough, ED specialist at Northwestern, in month 13 following surgery.

Due to schedule problems, I was unable to see him until month 16. My

intent was to get right into injections, but by month 16 I was doing very

well with Cialis/Viagra (has anyone EVER benefitted from Muse?) and getting

stronger and stronger without any meds. Jeff urged me to be a little

more patient and not change anything I was doing. I followed his advice

and by month 18 I was using meds more for recreational use than necessity.

Today, at 24 months, I can take them or leave them.

Through it all, my PSA post surgery has vacillated between

0.0 and 0.1 which I believe is statistically the same. I have no reason

to believe my test taken last week will be any different.

In sum, I am very pleased with my choice of surgeons,

medical center and procedure based on the outcomes. At Northwestern's

invitation I have joined their list of reference patients who are available

to talk to prospective patients about the process and program at

Northwestern. When I receive a call at home from someone who is where I

was two years ago, I am very careful to point out the " Your Mileage May

Vary " considerations but, if I had it to do over, I would not change a

thing. Could the outcome have been the same with open RP? I

am certain it could have been but not at all certain that it would

have been.

I do agree with another poster who pointed out that these

forums tend to be overpopulated with cancer patients who

are seeking input to assist them with their decision making or are

having problems and are seeking direction. It is unfortunate because it

may give the impression to newly diagnosed readers that there are

no patients with satisfactory results. It would be great if people

who went through the process and recovered very nicely remained in

touch with the forums but that is not the way of the world. As

time passes I find myself viewing my summer of 2007 " ordeal "

as no more or less eventful than an appendectomy I had

in " 84. Yep it happened and now it's behind me.

Best regards to all.

Subject: Discussions on open verses robotic

To: ProstateCancerSupport

Date: Wednesday, August 26, 2009, 6:09 AM

It isn't often that I

intervene these days, but here I'll reiterate the group maxim.

Don't jump into treatment

before you are informed - make the decision yours in consultation with the

ones who count in your life.

Some information comes from

experience, others come from research projects, some comes from discussion

with medics and fellow patients. At the end of the day it is down to personal

choice, what is right for you and yours.

It perhaps doesn't mattter

too much who invented what and when. It matters that people know what is

looks most attractive for them based on what they have found out.

Terry and other experienced

members try to flag up possible contrasts between word of mouth and

research. Well worth taking into account.

If we listened to the best

stories of any procedure, everyone whould use that one, equally if the worst

stories of the same procedure were the only ones about no one would use it.

My take on robotic is that

in the right hands it can provide a faster recovery period, with less

blood loss and gives an expert a better view of the area to be worked on

(as does laproscopic) . I think it takes a special surgeon to operate the kit

and just maybe then might have the edge on the open surgery but....

[Guest guest]

:

From a " neighbor " in the Chicago 'burbs,

congratulations and continued good health. Your essay was a breath of fresh air

and opens up a line of dialogue to which I have not been exposed or at least

participated. Apparently I'm one of those patients who's gone to the docs who

treat the obese 70 year olds with diabetes in the 'burbs. I want to be

quick to point out that the substandard treatment I've received has been from

urologists only. I am starting today with an IMRT course of treatment from a radiological

oncologist who seems to be on top of his game, and, I pray, is. The urologists

, on the other hand, have been significantly less than professional. I've

ticked off enough of my sad story on these pages and choose not to bore the

reader again, but, from a botched TUMT to a blatant effort to insist that my

treatment options have been misguided and everything in between, I've

received some truly awful care.

So, the question is, is there that much difference between the

quality of care in the 'burbs (I'm in the Fox Valley, but it could be 25 miles

out in any big city) and what one would receive at a large teaching hospital in

the city? I'm sure I'd expect some differences, but does that justify having to

drive 50-60 miles round trip in brutal traffic every day for the next 8 weeks? I've

started on my path to cancer-free existence, but I raise the question on behalf

of those who haven't and may be sitting 25 or 30 miles from downtown somewhere

and wondering whether to stay local or go into the city. Perhaps I sound naive,

but is the bar set that much higher at a Northwestern, Illinois or U.C.? It

might be illustrative to those who haven't chosen a " final step " or

even those who've just been diagnosed to kick this question around.

Tom Lauterback

From:

ProstateCancerSupport

[mailto:ProstateCancerSupport ] On Behalf Of Carroll

Sent: Monday, August 31, 2009 8:16 AM

To: ProstateCancerSupport

Subject: Re: Discussions on open verses robotic

As I write this, I am awaiting the results of a PSA test

from a sample drawn last week.

Two years ago this month I had a robotic

laparoscopic RP at Northwestern University Medical Center in Chicago. The

surgeon who performed the surgery had performed about 300 such procedures per

year for a few years prior to accepting me as a patient. I say

" accepting " because he and Northwestern track surgical outcomes for

5 years and I am convinced that they will reject cases that are predicted to

have poor outcomes in order to elevate their statistical performance.

My suburban urologist who performed my biopsy said as much when he advised,

" IF they take you downtown, you will do

great. They only take good patients. I get stuck doing the 70

year old obese patients with diabetes. " I know one can read a lot

into that comment and I will leave you to your interpretations, but I agree

with the sentiment that a major med center with a well recognized specialty

program is, shall we say, conscious, of their results.

Anyhow, I had the surgery and, although I was in the OR

for 6 hours, was released from the hospital to return home the day

following the procedure. Catheter for 10 days. When the catheter

came out I was prepared with a box of adult diapers (48 count) and heavy duty

pads. I used a couple of the diapers and then wore a pad for a few days

while at work just in case I had an accident. I didn't. Within a

few weeks of the surgery I had zero leakage and disregarded incontinence as

an issue.

I did go on a Muse/Cialis/Viagra rehab program with little

results for the first several months. My surgery was full nerve sparing

and I believe my surgeon prolonged the surgery (remember, it was six hours

long) in a very dedicated effort to minimize disruption/damage to nerve and

vascular bundles that he and I discussed at length before the surgery.

By the one year mark I was recovering function rather well

but was not completely satisfied. I made an appointment to see Jeff

Albough, ED specialist at Northwestern, in month 13 following surgery.

Due to schedule problems, I was unable to see him until month 16. My

intent was to get right into injections, but by month 16 I was doing very

well with Cialis/Viagra (has anyone EVER benefitted from Muse?) and getting

stronger and stronger without any meds. Jeff urged me to be a little

more patient and not change anything I was doing. I followed his advice

and by month 18 I was using meds more for recreational use than necessity.

Today, at 24 months, I can take them or leave them.

Through it all, my PSA post surgery has vacillated between

0.0 and 0.1 which I believe is statistically the same. I have no reason

to believe my test taken last week will be any different.

In sum, I am very pleased with my choice of surgeons,

medical center and procedure based on the outcomes. At Northwestern's

invitation I have joined their list of reference patients who are available

to talk to prospective patients about the process and program at

Northwestern. When I receive a call at home from someone who is where I

was two years ago, I am very careful to point out the " Your Mileage May

Vary " considerations but, if I had it to do over, I would not change a

thing. Could the outcome have been the same with open RP? I

am certain it could have been but not at all certain that it would

have been.

I do agree with another poster who pointed out that these

forums tend to be overpopulated with cancer patients who

are seeking input to assist them with their decision making or are

having problems and are seeking direction. It is unfortunate because it

may give the impression to newly diagnosed readers that there are

no patients with satisfactory results. It would be great if people

who went through the process and recovered very nicely remained in

touch with the forums but that is not the way of the world. As

time passes I find myself viewing my summer of 2007 " ordeal "

as no more or less eventful than an appendectomy I had

in " 84. Yep it happened and now it's behind me.

Best regards to all.

Subject: Discussions on open verses robotic

To: ProstateCancerSupport

Date: Wednesday, August 26, 2009, 6:09 AM

It isn't often that I

intervene these days, but here I'll reiterate the group maxim.

Don't jump into treatment

before you are informed - make the decision yours in consultation with the

ones who count in your life.

Some information comes from

experience, others come from research projects, some comes from discussion

with medics and fellow patients. At the end of the day it is down to personal

choice, what is right for you and yours.

It perhaps doesn't mattter

too much who invented what and when. It matters that people know what is

looks most attractive for them based on what they have found out.

Terry and other experienced

members try to flag up possible contrasts between word of mouth and

research. Well worth taking into account.

If we listened to the best

stories of any procedure, everyone whould use that one, equally if the worst

stories of the same procedure were the only ones about no one would use it.

My take on robotic is that

in the right hands it can provide a faster recovery period, with less

blood loss and gives an expert a better view of the area to be worked on

(as does laproscopic) . I think it takes a special surgeon to operate the kit

and just maybe then might have the edge on the open surgery but....

[Guest guest]

> ... I am starting today with an IMRT course of treatment from a

> radiological oncologist who seems to be on top of his game ...

> So, the question is, is there that much difference between the

> quality of care in the 'burbs (I'm in the Fox Valley, but it

> could be 25 miles out in any big city) and what one would

> receive at a large teaching hospital in the city? I'm sure I'd

> expect some differences, but does that justify having to drive

> 50-60 miles round trip in brutal traffic every day for the next

> 8 weeks?

I don't know the answer to that question. If I had to guess, I

would guess that, on average, patients at the famous teaching

hospitals and cancer centers do better than patients at the small

centers in the hinterland.

However, I would also guess that there are centers of excellence

everywhere. There can be a guy or gal working in a small town

who likes living there and doesn't want to move to Chicago or New

York, but who takes his work very, very seriously and does an

excellent job.

I'm not an expert, but it seems to me that radiation and surgery

are different in the demands they make on the practitioner.

Surgery requires great skill, steady eyes and hands, lots of

practice. Radiation requires serious attention to detail. I

think a klutz with shaky hands could still be a great radiation

oncologist if he takes his time, uses his head and is committed

to his patients.

You said that your rad onc " seems to be on top of his game " . I

suspect that's what counts. I don't see why he can't do just as

good a job as in the big city teaching hospitals.

Alan

[Guest guest]

> ... I am starting today with an IMRT course of treatment from a

> radiological oncologist who seems to be on top of his game ...

> So, the question is, is there that much difference between the

> quality of care in the 'burbs (I'm in the Fox Valley, but it

> could be 25 miles out in any big city) and what one would

> receive at a large teaching hospital in the city? I'm sure I'd

> expect some differences, but does that justify having to drive

> 50-60 miles round trip in brutal traffic every day for the next

> 8 weeks?

I don't know the answer to that question. If I had to guess, I

would guess that, on average, patients at the famous teaching

hospitals and cancer centers do better than patients at the small

centers in the hinterland.

However, I would also guess that there are centers of excellence

everywhere. There can be a guy or gal working in a small town

who likes living there and doesn't want to move to Chicago or New

York, but who takes his work very, very seriously and does an

excellent job.

I'm not an expert, but it seems to me that radiation and surgery

are different in the demands they make on the practitioner.

Surgery requires great skill, steady eyes and hands, lots of

practice. Radiation requires serious attention to detail. I

think a klutz with shaky hands could still be a great radiation

oncologist if he takes his time, uses his head and is committed

to his patients.

You said that your rad onc " seems to be on top of his game " . I

suspect that's what counts. I don't see why he can't do just as

good a job as in the big city teaching hospitals.

Alan

[Guest guest]

I live in Dupage County. I have been very pleased with my urologist from Central Dupage Hospital. He is a young man, who outlined to me several courses of action including AS, surgery and brachytherapy. He didn't try to sway me one way or the other, although he wasn't high on External Beam Radiation. He said if I chose surgery he would like to be the surgeon, but also said I should consider Northwestern. When I pursued brachy, he recommended me to Dr. Moran at Chicago Prostate Center in Lemont, where I received excellent treatment. My urologist maintains contact with Dr Moran, and consulted with him (without any prompting from me) after I had a bounce in my PSA.

Discussions on open verses roboticTo: ProstateCancerSupport Date: Wednesday, August 26, 2009, 6:09 AM

It isn't often that I intervene these days, but here I'll reiterate the group maxim.

Don't jump into treatment before you are informed - make the decision yours in consultation with the ones who count in your life.

Some information comes from experience, others come from research projects, some comes from discussion with medics and fellow patients. At the end of the day it is down to personal choice, what is right for you and yours.

It perhaps doesn't mattter too much who invented what and when. It matters that people know what is looks most attractive for them based on what they have found out.

Terry and other experienced members try to flag up possible contrasts between word of mouth and research. Well worth taking into account.

If we listened to the best stories of any procedure, everyone whould use that one, equally if the worst stories of the same procedure were the only ones about no one would use it.

My take on robotic is that in the right hands it can provide a faster recovery period, with less blood loss and gives an expert a better view of the area to be worked on (as does laproscopic) . I think it takes a special surgeon to operate the kit and just maybe then might have the edge on the open surgery but....