Since 2003, City of Hope has been performing prostatectomy using the da Vinci® surgical system (DVP), allowing our physicians to take a giant leap forward in the treatment of prostate cancer. The robotic technique provides unparalleled surgical accuracy to significantly reduce blood loss and improve postoperative recovery.  City of Hope performs more robotic assisted prostatectomies than any other medical center in the Western U.S and is second in the nation.

Patients experience significantly less pain and less blood loss than those undergoing conventional “open incision” procedures. In addition, patients tend to enjoy quicker recovery time.
A traditional, open radical prostatectomy requires two days hospitalization and recovery lasting about 2-3 months. With robotic assisted surgery the recovery time is as little as two weeks – a greater than 50 percent reduction in recovery time.

The department of Urologic Oncology at City of Hope specializes in the diagnosis and treatment of prostate cancer, bladder cancer, kidney cancer, and other urologic malignancies, providing therapies for patients that not only treat the disease but also attempt to achieve the best quality of life.  Since 2000, we have been using state-of-the-art minimally invasive techniques for the treatment of urologic malignancies.  Both the institution and the department were recently named as “America’s Best Hospitals” in cancer and urology by U.S. News and World Report.   We were the first regional cancer center to implement and subsequently advance the use of standard laparoscopic techniques for the treatment of prostate and bladder cancers.  
 
In 2003, after an initial experience with over 500 laparoscopic radical prostatectomies we implemented the use of the da Vinci® surgical system into our practice.  Since then, we have become the busiest minimally invasive and surgical robotics program worldwide and have performed over 3,100 robotic prostatectomies.  In 2007, we performed approximately 721 robotic prostatectomies.
 
The robotic program at City of Hope includes robotic and oncology fellowship trained surgeons, fellows, a dedicated operating room team, nurse practitioners, physician assistants, and research coordinators.  We currently have four new generation, four-arm robotic systems, including the da Vinici S High Definition platform.  All of our procedures are performed in minimally invasive operating theatres, utilizing Karl-Storz OR1ä integrated and automated suites.
 
The operation typically takes 2 to 3 hours, and is performed under general anesthesia.  Most patients have an estimated blood loss of 300 milliliters, and therefore less than 3% of patients are expected to need a blood transfusion).  Most patients typically spend one night in the hospital, and can expect to get discharged the following afternoon if their laboratory tests are acceptable, pain is controlled with oral medications, and they are able to tolerated oral liquids.  Patients are discharged with an indwelling foley catheter which will be removed in the clinic 5-7 days after the operation.  Patients who do not reside in the local vicinity, can sometimes have their catheters removed by their community urologist.  At the first post-operative visit, we review and discuss pathology results, and potential need for any adjuvant therapies if indicated. Most patients have a convalescence period of 2-3 weeks, and can expect to return to their normal activity 4 weeks after surgery.  
 
Based on our most recent data review, our pathological positive margin rate is below 20%.  The average time to regain continence is about 40 days, with almost 96% of patients reporting continence at one year after surgery.   Patients may be enrolled in a continence rehabilitation program to strengthen their pelvic muscles and accelerate their recovery.  Furthermore, depending on age and pre-operative erectile function, approximately 70-80% of patients can expect to have return of potency with or without the use of oral medications.