Kentucky's first robotic procedure treats prostate

Today, UK Hospital announced the state’s first laparoscopic radical prostatectomy utilizing robotic instruments from the beginning to the end of the surgical procedure. Stephen Strup, M.D., associate professor of surgery and director of Minimally Invasive Urologic Surgery, Division of Urology , UK College of Medicine, performed the procedure using the da Vinci® Surgical System, developed by Intuitive Surgical.

On Feb. 6, 2004, Tony Curtsinger, age 64, of Lexington, was the first patient in Kentucky to undergo a laparoscopic radical prostatectomy utilizing the robotic system surgical system. A laparoscopic radical prostatectomy is a minimally invasive surgical procedure used to remove the prostate in order to treat prostate cancer.

“Robotic technology is an excellent addition to the minimally invasive surgical program at UK,” Strup said. “The addition of the robot will allow us to continue to expand our minimally invasive program for prostate surgery as well as other urologic procedures.”

Prostate cancer is the second leading cause of cancer death in men in the United States with approximately 40,000 dying of it each year. Prostate removal is the most common procedure performed on men with prostate cancer and is typically performed through large, open surgical incisions, which often result in lengthy and uncomfortable patient recovery.

“Traditional radical prostatectomy procedures often result in lengthy and uncomfortable patient recovery. At UK Hospital, surgeons now are able to perform this procedure through smaller incisions, significantly reducing the patient's pain, blood loss, and recovery time,” said Robert Mentzer Jr., M.D., the Frank C. Spencer Professor and Chairman, Department of Surgery, UK College of Medicine.

The procedure is performed under general anesthesia and usually requires from two and a half to four and a half hours to complete, depending upon the patient’s anatomy. Surgeons make an incision from just below the umbilicus (“belly button”) to the pubic bone to approach and remove the prostate.

The robotic system at UK allows surgeons to insert instruments through tiny ports, placed within one-centimeter incisions in the body. Surgical procedures using the robotic system require a minimum of three incisions; one for a camera and two for surgical instruments. Surgeons can rotate the instruments 360 degrees through the incisions. The robotic surgical system allows the surgeons to perform enhanced surgical procedures by translating the natural hand, wrist and finger movements on the system controls to corresponding movements of the instrument tips.

“The robot allows you to function with three-dimensional vision and move instruments freely. Sewing with the robot is infinitely easier to learn,” Strup said.
Before UK Hospital purchased the robotic system, Strup performed Kentucky’s first minimally invasive laparoscopic radical prostatectomy in September 2003. Strup has performed more than 200 laparoscopic radical prostatectomies to date both with and without the surgical robotic system.

“At UK, we have the best of both worlds in that we have the ability to perform the procedure with or without the robot. By incorporating the robot we will be able to expand this procedure to other faculty physicians quite readily,” Strup said.

"At UK Hospital, we are proud to be leaders in Kentucky health care,” said Joseph O. Claypool, FACHE, director of UK Hospital.

“We have an outstanding urology program and one of the best minimally invasive surgery programs in the country, and we offer state-of the-art minimally invasive management of most urologic disease. This surgical procedure is an excellent example of how minimally invasive surgery can provide benefits to the health care provider and the patient,” Claypool said.

UK Hospital purchased the $1,290,000 robotic system in December 2003. UK surgeons plan to use the robotic surgical system for vascular, neurological, pediatric and cardiothoracic surgical procedures.