Where do I start ?

Hi Happychappy,

You seem to have settled on surgery and there are very experienced surgeons at the London Teaching Hospitals. I have read good reports of The Royal Marsden and Guys and you could contact others too to ascertain experience and skills of surgeons. There are major hospitals you could contact in Birmingham and Leeds among others who may have a lot of experience with robotic surgery but certainly with conventional open surgery. The latter does mean longer healing time but some surgeons prefer it to robotic with eventual outcomes similar but your choice.

You really need to contact hospitals direct if your GP cannot help you, as a few men that may relate experiences of hospitals, good or bad may not necessarily reflect the overall performance of individual surgeons. It also has to be remembered that some prostates pose greater difficulty to remove with good effect than others, so some surgeons prefer to do the easier ones which makes their overall record look better.

Thanks Lynn and Barry

The surgeon explained both himself and a colleague do the robotics and share the operations, helping or assisting the other?

Lynn I am not intent on robotics, just that I feel more comfortable with surgery in the hope that everything is contained, there are no positive margins and everything is gone ? I know its a bit simplistic and I am prepared for the side effects, as you pointed out in an earlier post, its the living first and the rest can then follow.

The surgeon I have seen has only discussed robotic surgery, he didn't dismiss a normal laparoscopic or open surgery, just if I go for surgery this was the type of surgery he would do?

As I only get the one opportunity to try and get it right, I am looking towards finding a very experienced surgeon or centre, I would prefer not to have to travel but if this has the best outcome then that is not an issue

I have been looking at the Marsden and the Cambridge University cancer centre, which appears to carry out very many procedures and looking at the literature on the BAUS website they suggest or recommend that centres should perform 150+ procedures a year, likewise they give guidance on how many procedures a surgeon may take to be proficient ?

I know the medical world needs guinea pigs for surgeons to gain experience on and maybe I am being selfish, but I simply want to give myself the best chance.

Capitalman also chose from this list - his life has been devastated and the aftercare was shocking so choose wisely. Sometimes the ones who get on the top lists are simply the ones who can afford big marketing budgets.

Happychappy, once they have bought a machine there is probably a lot of pressure to justify it via frequent use. Is it worth asking your surgeon how many normal LRPs he has done and whether you can have that instead?

Out of interest , how do they teach new surgeons coming up through the ranks to do these operations ? I made it very clear to my surgeon that I didn't want any students practicing on me , because I was terrified of ED ( which i have anyway ) , yet to fill the consent form in properly I had to agree to students being taught . I HAD to tick the box that said it was a teaching hospital etc. I'm just interested as these students have to learn SOMEWHERE I suppose

Edited by member 01 Jan 2016 at 17:35  | Reason: Not specified

All the surgeons who do robotic have considerable previous experience with open surgery. Indeed it has happened, though thankfully rarely, that there has been a problem with the robot or it has become apparent during the course of surgery that open would be preferable for the particular patient. In these situations the fall back position is to continue with open. There is of course a first time for everything and maybe surgeons when they first start do only part of of the operation and under instruction, gradually doing more of it. It seems to me that operating on dead bodies might be helpful but I don't know if this is done. When highly proficient, it's a question of the surgeon adapting to use a robot. I did see this demonstrated some time ago, the surgeon practicing on a special dummy but don't know if this is now part of the training. It would be interesting to find out!

Don't be put off by any of this, surgeons in the UK are generally pretty competent but like any other group some are better than others.

All the best for tomorrow, I don't recall any swelling or any real long term pain, take it easy but keep mobile.

Thanks Chris

Good luck for a very positive, long term outcome for you Happychappy.

Your wife will be there nagging and alternately mollycoddling you I'm sure.

Do as you are told by your care team, don't rush anything, and you'll be fine

All the best

Sandra

Thanks all, came out last night, all went well but will get the results in 6 weeks, the surgeon did nerve sparing on one side only and took a wide margin on the other. Just trying to get used to the catheter which is in for two weeks. Pain is ok, more tummy discomfort around the wounds.

All in all an interesting experience and funny how my views changed as Lyn pointed out, firstly ED and continence were important then as I finally realised this is really serious, I then viewed living as the ultimate priority.

The surgeon was as confident as surgeons go, in so far as he said, subject to pathology, he felt this surgery should be all that is required, but we shall see, my only regret was having to go private. I know this was down to me and reading up so much and everything pointed to finding the best surgeon one can, best being a surgeon with lots of robotic experience, and this chap had done over 500 and he gave confidence in everything he said, so although I have paid my taxes and NI for 45 years, I felt this money well spent.

Now to wait for the catheter to go and see how well the continence goes, I worked on pelvic floor for the month prior to surgery, but I imagine that's a new journey. Already started cranberry juice, lots of water and diet, thanks to the posters, and all the information on this marvellous website, thanks again : )

Hi Chris, thanks, yes waiting for the first : ) funny how some things become important, trying to keep a light diet, soups and things, but I'm sure my day will come 😄