need help again

12 years 10 months ago #37827 by mmc
Replied by mmc on topic need help again
Dana,

You were reading the wrong information if you read that robotic is the best. The jury is still out on the actual effectiveness of the surgery compared to open. That requires lot of surgeries in order to do the statistical comparisons.

As Pat said elsewhere, robotic is 'relatively' new when it comes to cystectomies. Some doctors have done a lot and some doctors are just getting started (learning).

Hospitals buy the things because one doctor or department pushes for it because the sales rep bought them a trip or a dinner or golf at a great course or whatever and then the hospital encourages doctors to use them so they can show a return on the investment. Once a doctor uses the robot a lot, in a lot of different situations, he/she builds a high proficiency with them. Using them can be easier/safer in the long term but not during the learning curve (which again, is based on the frequency of that particular surgeon using it in a variety of situations).

The most typical for neobladder surgery is open surgery. Don't be concerned about the 'type' of surgery right now. Open is what his top surgeon is best at and it therefore what he should do.

Mike

Age 54
10/31/06 dx CIS (TisG3) non-invasive (at 47)
9/19/08 TURB/TUIP dx Invasive T2G3
10/8/08 RC neobladder(at 49)
2/15/13 T4G3N3M1 distant metastases(at 53)
9/2013 finished chemo -cancer free again
1/2014 ct scan results....distant mets
2/2014 ct result...spread to liver, kidneys, and lymph...

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12 years 10 months ago #37788 by Patricia
Replied by Patricia on topic need help again
Well there is good information, bad information and outdated information on the net and we all know how confusing it is when you're trying to do research on a very personal matter. Its quite overwhelming. Here is an article that was posted yesterday in Science Daily on overselling Robotic Surgery...an observation by Johns Hopkins which is #1 in Urology here.
www.sciencedaily.com/releases/2011/05/110518092040.htm
One of the things discussed at many of the uro conferences was the fact that the only way a surgeon gets to practice on these DaVinci machines is with a real person.....I wouldn't want to be that guy in the first 50.
pat

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12 years 10 months ago #37786 by Dana
Replied by Dana on topic need help again
I know for a fact that he is one of the top urologists in his field at one of the best university hospitals.
My main concern was finding a good doctor, the hospital "care" isn't the best in Greece, but the doctor is very talkative and keen to explain everything we want to know in detail.
He told me not to overdo it on the Internet becuase sometimes being overwhelmed with so much info doesn't always help (that is how I got the idea that only robotic surgery was the best).

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12 years 10 months ago #37784 by sara.anne
Replied by sara.anne on topic need help again
It is important to know how many procedures he has done. However, I would not be concerned about the robotic aspect. It is the "latest" thing...every hospital has to have a machine or two...and doesn't always have very expereienced surgeons to run them. My internist ran into some real problems with prostate surgery due to this!!! You want the most experienced surgeon...period.

Sara Anne

Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society
Forum Moderator

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12 years 10 months ago #37782 by Dana
need help again was created by Dana
Just talked to the doctor, he said to meet with us and will explain everything in detail. He is actually quite nice compared to many doctors I have spoken to.
I haven,t got a clue how many procedures he has done (will ask that). If it is less than 50 am I in trouble?
Also just found out that the surgery won't be robotic, can someone please tell me if this is bad?
Everything I have read so far is robotic surgery and now I am a little worried.

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