Prostate Cancer Specialists on Minimally Invasive Surgery

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Guest:  Dr. Stephen Savage - Urology

Host:  Dr. Linda Austin – Psychiatry 

Dr. Linda Austin:  I’m Dr. Linda Austin and I’m interviewing Dr. Stephen Savage who is Medical Director of Minimally Invasive Urology here at the Medical University of South Carolina.  Dr. Savage, earlier, we covered some of the basics of minimally invasive urologic surgery.  Let’s turn our attention, now, to how these techniques are used for treatment of prostate cancer.  Can you describe that, please?

Dr. Stephen Savage:  Sure.  As minimally invasive surgical options increased, related to urologic disease, we changed from procedures where we simply removed an organ to procedures where we removed organs and did reconstruction and then did finer surgery.  This lent itself towards the treatment of prostate cancer.  Surgical treatment for prostate cancer, radical prostatectomy, is something that, 30 years ago, was associated with a lot of morbidity, meaning, problems related to the surgery as the patient recovered.

Dr. Linda Austin:  Such as?

Dr. Stephen Savage:  Such as blood loss related to the surgery, pain related to the surgery, urinary incontinence after the surgery, and erectile dysfunction related to the surgery.

Dr. Linda Austin:  The dreaded impotence.

Dr. Stephen Savage:  That’s correct.  Over time, we’ve learned what’s important in the surgical technique to prevent those types of things.  So, as minimally invasive surgery became used in many different areas of urologic and other surgeries, we began to apply that to laparoscopic radical prostatectomy, and this really began 10 years ago.  In 1997 was when that really began to increase.  The advantages of laparoscopic surgery, which everybody knows about, are small incisions, quicker recovery.  So, that often lends itself to some type of an appeal to the patient who needs to undergo this type of surgery.  

For prostate cancer, what I, in particular, and the other people who do laparoscopic, or minimally invasive, surgery for prostate cancer find appealing is the magnification, the ability to get into small areas and the decreased blood loss related to the procedure, as it’s done laparoscopically.  For instance, the prostate itself is tucked in a very difficult area, which is why there are many different approaches to get to it.  Laparoscopic surgery allows the surgeon to bring a camera down into a very small area and work in that area with these long instruments.  

What we’re able to do with magnification is do that same type of surgery.  Now, it’s an ex

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