Textbook of
Robotic Urologic
Surgery.



Release Date:
January, 2007

Michael Esposito,
Vincent Lanteri
&
Jeffrey Stock

SURGERY TECHNOLOGY
Robots, doctors team to save lives

By Raymond Baldino
Staff Writer

Doctors Vincent J. Lanteri and Michael Esposito of Hackensack, who have saved hundreds of prostate cancer patients in the last five years, said they enjoyed seeing many of their former patients in a non-clinical setting early this November. The patients had gathered to celebrate a milestone in the doctor's careers, and the procedure that saved their lives. 

Each of the cancer survivors who met in Bergen County last month to celebrate the doctor's 750^th successful prostate removal using a new surgical procedure had the same thing in common -- they had all received "bloodless" surgery. The procedure features five adhesive strip-sized incisions to the patients' abdomen that were accessed by a remote controlled robot.

Lanteri, who said that as late as 2003 there was still skepticism about the technique, said what is called robotic radical prostatectomy had become the new "gold standard" in prostate surgery. He and Esposito are considered pioneers in the field, among the first doctors to use robotic surgery when it became available.

Since then, they have performed 750 robotic radical prostate surgeries, the most in New Jersey, and written a textbook on Robotic Urologic Surgery.

"We saw this was the future, and we took a gamble," said Lanteri. "We took a more difficult road and pioneered this technique."

By using the robotic laparoscopic technique, the doctors are able to avoid some of the complications of traditional, invasive surgery used in prostate removal. Recovery time is shortened significantly, with patients leaving the hospital after one night, as opposed to three or four in traditional surgery, according to a report published in M.D. News's New Jersey edition.

Also, patients experience much less pain after the operation -- practically no pain, said Esposito. 

During the operation, a remote controlled, four-armed robot is used to remove the prostate, as one doctor stands over the patient and another manipulates the machine to perform the surgery, using a computer screen image to make his incisions.

Once a surgeon is trained in the technique, Esposito said, it is both safer and quicker than open surgery. While he and his partner needed seven to eight hours to perform the technique when they learned five years ago, today they can perform it in less time than their counterparts performing traditional surgery. Also, the arms of the robotic surgeon, called a daVinci machine, does not experience the tremor that human hands do.

Because the operation is considered "bloodless" - causing an estimated 1/10 of the blood loss of traditional surgery, patients rarely require a blood transfusion. Rather than concentrate on controlling blood loss, surgeons are sometimes able to preserve continence and erectile function better than in traditional surgery, according to the M.D. News report.

Also, surgeons obtain better vision using a laparoscopic camera that gives them a magnified, three-dimensional image, than they can during open surgery, where bleeding can obstruct a clear view. Another benefit to not needing a blood transfusion is that the surgery can be performed on Jehovah's witnesses and other whose religious beliefs would  have previously prevented them from undergoing surgery.

Last month, as hundreds of patients gathered in Bergen County to thank the doctors who saved their lives, some of them were put in the unusual position of also thanking a robot. Also present at the ceremony, and available for the former patients to "test-drive" was the same machine that had saved their lives, that doctors Esposito and Lanteri have become experts at using.

"We're delighted that patients are happy they're Cancer free. We're delighted we can offer them this treatment, as opposed to a more morbid procedure, and we're delighted we can do it in a high quality fashion," said Esposito.

 

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 Radical Prostatectomy (prostate removal)

New Jersey Center for Prostate Cancer and Urology has two locations:
in Maywood at 255 W. Spring Valley Avenue and in Monmouth Medical Center at 255 Third Ave., Long Branch.
Call us for more information: Maywood (201) 487-8866 Monmouth Medical Center (732) 403-5506