Robotic Surgery Reduces Risk of Blood Loss | News | Loyola Medicine
Tuesday, May 24, 2016

In Obese Prostate Cancer Patients, Robotic Surgery Reduces Risk of Blood Loss and Prolonged Hospital Stays

robotic surgery

MAYWOOD, IL – In obese prostate cancer patients, robotic-assisted surgery to remove the prostate reduces the risk of blood loss and prolonged hospital stays, a Loyola Medicine study has found.

The study by senior author Gopal Gupta, MD and colleagues is published in the journal Current Urology. Dr. Gupta is an assistant professor in the Department of Urology of Loyola University Chicago Stritch School of Medicine.

Researchers examined records of 9,108 obese men who underwent radical prostatectomy (removal of the prostate gland and some surrounding tissue). Among all patients, 60.4 percent underwent robotic-assisted radical prostatectomy and 39.6 percent underwent open prostatectomy.

Compared with patients who had open surgery, patients undergoing robotic-assisted surgery were 83 percent less likely to require blood transfusions and 72 percent less likely to require prolonged hospital stays. But robotic-assisted surgery did not reduce the risk of infections and other complications, the study found.

The robotic system allows surgeons to operate through a few small incisions. Movements by the surgeon's hand or wrist are translated into highly precise movements of the surgical instruments.   Every maneuver is directed by the surgeon, in real time, as the surgeon views a magnified, 3D, high-definition image of the surgical site.

Prostate cancer is the most common solid organ cancer in men in the United States. One in six men will develop prostate cancer over their lifetimes, and many will choose to have radical prostatectomies. In the past decade, the use of robotic-assisted radical prostatectomy has surpassed that of open surgery.

More than one-third of adults in the United States are obese. Obese patients can be challenging, because many have related conditions such as diabetes, heart disease and obstructive sleep apnea that can increase the risk of blood transfusions, complications and prolonged length of stay.

Researchers concluded the study results have these implications:

  • The finding that robotic-assisted surgery reduces blood transfusion and prolonged length-of-stay even in obese patients offers a better understanding of the value of robotic surgery in challenging patients.
  • For urologists, the finding that robotic and open surgery have similar complication rates implies that both techniques remain interchangeable. The surgeon’s comfort level should dictate which surgical approach is used.
  • For obese prostate cancer patients, the broad findings suggest that both surgical approaches are feasible and safe.

In the study, researchers examined records from the 2009-2010 Nationwide Impatient Sample maintained by the Agency for Healthcare Research and Quality.

Dr. Gupta’s co-authors are Chandy Ellimoottil, MD, (first author), Robert Blackwell, MD, Adam Kadlec, MD, Kristin Greco, MD, and Marcus L. Quek, MD, all of Loyola; and Florian Roghmann, MD, Maxine Sun, MD and Quoc-Dien Trinh, MD, of the University of Montreal Health Center.

The study is titled, “Open Versus Robotic Radical Prostatectomy in Obese Men.”

About Loyola Medicine and Trinity Health

Loyola Medicine, a member of Trinity Health, is a quaternary care system based in the western suburbs of Chicago that includes Loyola University Medical Center (LUMC), Gottlieb Memorial Hospital, MacNeal Hospital and convenient locations offering primary and specialty care services from 1,877 physicians throughout Cook, Will and DuPage counties. LUMC is a 547-licensed-bed hospital in Maywood that includes the William G. and Mary A. Ryan Center for Heart & Vascular Medicine, the Cardinal Bernardin Cancer Center, a Level 1 trauma center, Illinois's largest burn center, a certified comprehensive stroke center and a children’s hospital. Having delivered compassionate care for over 50 years, Loyola also trains the next generation of caregivers through its teaching affiliation with Loyola University Chicago’s Stritch School of Medicine and Marcella Niehoff School of Nursing. Gottlieb is a 247-licensed-bed community hospital in Melrose Park with 150 physician offices, an adult day care program, the Gottlieb Center for Fitness, the Loyola Center for Metabolic Surgery and Bariatric Care and the Loyola Cancer Care & Research at the Marjorie G. Weinberg Cancer Center at Melrose Park. MacNeal Hospital is a 374-bed teaching hospital in Berwyn with advanced inpatient and outpatient medical, surgical and psychiatric services, advanced diagnostics and treatments. MacNeal has a 12-bed acute rehabilitation unit, a 25-bed inpatient skilled nursing facility, and a 68-bed behavioral health program and community clinics. MacNeal has provided quality, patient-centered care to the near west suburbs since 1919.

Trinity Health is one of the largest multi-institutional Catholic healthcare systems in the nation, serving diverse communities that include more than 30 million people across 22 states. Trinity Health includes 92 hospitals, as well as 109 continuing care locations that include PACE programs, senior living facilities and home care and hospice services. Its continuing care programs provide nearly 2.5 million visits annually. Based in Livonia, Mich., and with annual operating revenues of $18.3 billion and assets of $26.2 billion, the organization returns $1.1 billion to its communities annually in the form of charity care and other community benefit programs. Trinity employs about 129,000 colleagues, including 7,800 employed physicians and clinicians. Committed to those who are poor and underserved in its communities, Trinity is known for its focus on the country's aging population. As a single, unified ministry, the organization is the innovator of Senior Emergency Departments, the largest not-for-profit provider of home health care services—ranked by number of visits—in the nation, as well as the nation’s leading provider of PACE (Program of All Inclusive Care for the Elderly) based on the number of available programs.