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In Japan, several health care robots for the home are already on the market. Japanese engineers expect robots to be available for commercial household use by 2010. The domestic market for Japanese commercial and industrial robots may be as high as $8 billion dollars by this time, and like most Japanese electronics, will be marketed to the industrialized world shortly thereafter.

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Prostate cancer (PCa) is the most common non-skin cancer in men – about 30 percent of all cancers are prostate and 15 percent of men are likely to get it.

Radical prostatectomy has the highest cure rate for an organ-confined disease of all treatments although 10-20 percent have additional prostatic disease after pathologic evaluation.

Traditionally, surgery has been done “open” (retropubic or perineal), but since 1997 the laparoscopic approach has gained acceptance. Around 2001, the robotic approach started to become idealized. By 2005, about 20 percent of radical prostatectomies were performed with the da Vinci™ surgical system from Intuitive Surgical. Although the da Vinci robot was named after Leonardo da Vinci, who made the first robot, the term was coined by Capek in a Czech play in 1921. Technically, the da Vinci™ Surgical System is not technically a robot, it’s a “remote computer assisted tele-manipulator.”

Robotic prostate surgery has some advantages for the patient. During surgery, patients tend to lose less blood, require fewer transfusions (1-2 percent instead of 5-10) and have shorter catheterization times. The latter can mean less infection, less urinary extravasation and a faster return to continence for patients. Patients also suffer less post-op pain because of a shorter incision, which helps them resume normal activities more quickly (within 92 hours instead of 4 weeks) as well as a shorter hospital stays (1.2 days instead of 2.5).

Still, controversy exists about the advantages, disadvantages and cost-effectiveness of the robot. All approaches (open, laparoscopic or robotic) provide similar overall health and quality of life outcomes: positive margins (2-19 percent); Prostate-Specific Antigen (PSA) recurrence free survival (80-95 percent after 3 years); continence at one year (80-95 percent); potency at one year (55-85 percent); and overall complications (5-10 percent). They are also similar in cost, so doctors select one approach over another based upon the patient situation and achieve similar results.

We’ve come a long way from the days when the first open heart surgery operation took place in terms of cardiac rehabilitation programs. There may be a number of significant reasons for this progress including progress in the area of the surgery itself. One significant improvement is that of using robotic heart surgery and the impact that has on the recovery of the patient. The da Vinci surgical robot is being used quite regularly by skilled surgeons in the Chicago area.

The procedures are becoming more comfortable for the heart patients and thus an easier recovery. By using robotic-assisted surgical technique and allowing minimally invasive and extremely exacting surgical techniques, the patient has less trauma to their body, there is less pain and scarring which leads to faster healing and a reduction in the risk of infection. There is also the possibility of less blood loss during the surgery so the body is stronger coming out of the operation.

The use of robots in cardiothoracic surgery throughout the country may be on the increase but out of all of the hospitals, the Chicago area has perhaps some of the most prominent hospitals on the leading edge technology. The reasons for this commitment can be attributed to a number of reasons, but the number one reason is the patients. The focus on taking care of patients and on the path to healing is a driving force that allows this attention to detail. Being on the leading edge is not always the easy route to take.

Many places are limited by the cost, many are limited by ego or the fear to be the leader and some take the bull by the horns and step up to the task of figuring it out and getting it right. This type of leadership is common at Riverside and it bespeaks of the risks allowed and encouraged to help patients get in and get out with the least amount of trauma and injury. That is what doctors are and should be about. Do no harm. It is a long road to get people to understand that technology is a great assistant. For those who have been on the long road to being a trained surgeon it is hard to imagine wanting to take the time and effort to learn a new skill and become proficient at using a new tool.

In the United States and Canada it typically takes six to nine years as a resident to become a fully qualified cardiothoracic surgeon. This of course is after medical school and after undergraduate school. The dedication to their craft is undeniably astounding. The benefit to all this comes out when the patient now leaves the hospital after a few days instead of a few weeks. Not only are we able to do more with the heart and surgery, we are able to be more accurate and less invasive, all to the benefit of the patient.