During robotic surgery, the surgeon uses the assistance of a robot to operate on the patient through tiny holes in the abdomen instead of a large open incision. The robotic technology, cited as #1 in Forbes magazine's Five Robots That Will Change Your Life, consists of a surgeon's console that controls a tower with four working arms. One arm controls the three-dimensional camera's movement inside the body, while the remaining three arms hold specialized laparoscopic instruments. The robotic arms precisely replicate the surgeon's exact hand and finger movements from the console.
NewYork-Presbyterian/Columbia is one of a few select centers in the country and the first in New York City - to use the state-of-the-art High Definition daVinci-S Surgical System to peform robotic urologic surgery. We work very closely with the manufacturer of this system (Intuitive Surgical Inc, Sunnyvale, CA) to stay on the cutting edge of this technology.
Robotic prostatectomy, also know as robot-assisted laparoscopic prostatectomy, is the most advanced prostate cancer treatment option for men who are candidates for surgery. The procedure is performed through five tiny holes in the abdomen to remove cancerous tissue while preserving vital nerves and arteries that control bladder and sexual function.
In the hands of experienced robotic surgeons, robotic prostatectomy offers:
The daVinci Surgical System from Intuitive Surgical, Inc. enhances surgical capabilities, providing superior visualization, enhanced dexterity, greater precision and ergonomic comfort. As a result of these capabilities, surgeons can now perform even complex surgery using 1-2 cm incisions.
The precise dissection around the prostate using robot-assisted surgery allows for the safe removal of diseased tissue and preservation of healthy nerves and arteries that control normal bladder and sexual function. Studies demonstrate that the cancer control is excellent and comparable to the best data from traditional open surgery. Robotic prostatectomy has been performed in the United States for only 5 to 6 years. Therefore, the longest cancer control follow-up after robotic prostatectomy is approximately 5 years (Badani et al. Cancer 2007; 110(9):1951-1958). Robotic prostatectomy has excellent five-year cancer cure rates that are comparable to, if not better than, those obtained with open surgery. These results, coupled with improved sexual function after surgery, demonstrate the advantages of robotic prostatectomy.
Recovery of sexual function after prostate surgery can be variable. Data shows that return of sexual function is improved after robotic prostatectomy compared to open surgery (BJU Int. 2003;92(3):205-10). Our researchers found that in men with normal erection function prior to surgery, 93% to 97% were having sexual intercourse by one year postoperatively (Eur Urol. 2007;(3):648-57; BJU Int. 2006; 97(3):467-72). With enhanced nerve-sparing techniques available at NewYork-Presbyterian/Columbia, this recovery of sexual function can happen as soon as 3 to 6 months after the operation.
Kidney surgery is traditionally performed using an open approach that requires a large painful incision. Another approach is conventional laparoscopy, which is less invasive than open surgery, but limits the doctor's dexterity, visualization and fine hand control compared to open surgery. Robotic kidney surgery incorporates the advantages of both open surgery and traditional laparoscopy and applies them to a robot-assisted minimally invasive approach. Working closely , Dr. Badani and Dr. Menon of the Vattikuti Urology Institute have pioneered and standardized the techniques used for robotic kidney surgery.
Importantly, in many instances, preservation of normal tissue while removing only the diseased portion of the kidney – known as partial nephrectomy – is important. The precision and dexterity afforded by the daVinci Surgical System allows maximal preservation of normal kidney tissue while eliminating cancerous or diseased tissue.
Dr. Ketan K. Badani and Dr. Mani Menon publish the results of a study that follows the largest group of men in the world who have undergone robotic prostatectomy - this month in Cancer, the journal of the American Cancer Society.
Read the Press Release
The Department of Urology at Columbia University is a national leader in robotic prostatectomy and, working together with the National Cancer Institute-designated Herbert Irving Comprehensive Cancer Center, we are one of the nation's premier urologic cancer treatment facilities. The Robotics Center at NewYork-Presbyterian Hospital/Columbia University Medical Center is one of only a few medical centers in the world with the expertise to offer comprehensive, minimally invasive robotic surgery of the prostate (prostatectomy), kidney (nephrectomy), bladder (cystectomy), and adrenal gland.
Our internationally recognized robotic surgery team is led by Ketan K. Badani, MD, Director of Robotic Surgery in the Department of Urology at Columbia University. Recruited by Mitchell C. Benson, MD, Chair of Urology, and with experience in more than 600 robotic procedures, Dr. Badani is a world leader in robotic surgery. He was fellowship-trained in laparoscopic and robotic oncology under the mentorship of Mani Menon, MD, and spent six years at the Vattikuti Urology Institute in Detroit, Michigan, where robotic prostatectomy was developed and where more robotic prostatectomy procedures have been performed than any other hospital or medical center in the world. This experience and expertise is now available at NewYork-Presbyterian/Columbia.
Dr. Badani has worked extensively to develop new nerve-sparing techniques to preserve sexual function after robotic prostatectomy – without compromising cancer control. One of the nation's leading robotic surgery instructors, Dr. Badani has demonstrated these nerve-sparing techniques throughout the United States, as well as internationally in Canada, Spain, Austria, China, Malaysia, Venezuela, and India. Dr. Badani is also a noted author and lecturer on topics including sexual function, cancer control, and urinary continence outcomes after robotic prostatectomy.
In addition to being a gifted surgeon, Dr. Badani is very committed to working with the youth in the hospital community. Recently, Dr. Badani introduced a group of young people to the da Vinci robot—a technology that will no doubt be a part of their every day lives as adults. They had a chance to "operate" the robot and had an up-close view of this state-of-the-art piece of equipment. With any luck, there will be a future surgeon in the group!
Read the NY Daily News article | Watch the video on ABC7
Badani KK, Kaul S, Menon M. Evolution of robotic radical prostatectomy: assessment after 2766 procedures. Cancer. 2007;110(9):1951-1958
Rajesh Laungani, Sanjeev Kaul, Fred Muhletaler, Ketan K. Badani, James O. Peabody, Mani Menon. Impact of previous inguinal hernia repair on transperitoneal robotic prostatectomy. Can J Urol. 2007;14(4):3635-9.
Alok Shrivastava, Ketan K. Badani, Michael Fumo, Sanjeev Kaul, James O. Peabody, Mani Menon. Vattikuti Institute Prostatectomy: contemporary technique and analysis of results. Eur Urol. 2007;51(3):648-57.
Ketan K. Badani, Ashok K. Hemal, Michael Fumo, Sanjeev Kaul, Alok Shrivastava, Arumuga Kumar Rajendram, Noor Ashani Yusoff, Murali Sundram, Susan Woo, James O. Peabody, Sahabudin Raja Mohamed, and Mani Menon. Robotic Extended Pyelolithotomy for Treatment of Renal Calculi: A Feasibility Study. World Journal of Urology. 2006;24(2):198-201.
Ketan K. Badani, Ashok K. Hemal, James O. Peabody, Mani Menon. Robotic radical prostatectomy: The Vattikuti Urology Institute training experience. World Journal of Urology. 2006;24(2):148-51.
Adnan T. Savera, Sanjeev Kaul, Ketan K. Badani, Azedeh T. Stark, Nikhil L. Shah, Mani Menon. Robotic radical prostatectomy with the "veil of Aphrodite" technique: histologic evidence of enhanced nerve sparing. Eur Urol. 2006;49(6):1065-73.
Sanjeev Kaul, Adnan Savera, Ketan K. Badani, Michael Fumo, Akshay Bhandari, Mani Menon. Functional outcomes and oncological efficacy of Vattikuti Institute Prostatectomy with Veil of Aphrodite nerve-sparing: an analysis of 154 consecutive patients. BJU Int 2006; 97(3):467-72.
Follusho Ogunfitidimi, Mani Menon, Richard Sarle, Michael Fumo, Ketan K. Badani, Kaul Sanjeev. Robot assisted prostatectomy: A review of Vattikuti Institute Prostatectomy (VIP). 1500 cases. The Scientific World, Dec. 2005.
Ketan K. Badani, Akshay Bhandari, Ashutosh Tewari, Mani Menon. A comparison of two dimensional versus three dimensional suturing: Is there a difference in a robotic surgery setting? J Endourol. 2005;19(10):1212-1215.
Tewari A, Horninger W, Badani KK, Hasan M, Coon S, Crawford ED, Gamito EJ, Wei J, Taub D, Montie J, Porter C, Divine GW, Bartsch G, Menon M. Racial differences in serum prostate-specific antigen (PSA) doubling time, histopathological variables and long-term PSA recurrence between African-American and white American men undergoing radical prostatectomy for clinically localized prostate cancer. BJU Int. 2005;96:29-33.