December 02, 2009 16:35 ET

Robotic Surgery Expert Dr. David Samadi Part of a Growing Group of Experts Disputing Harvard Medical Study on Robotic Prostate Surgery

NEW YORK, NY--(Marketwire - December 2, 2009) - Medical experts are emerging to discount the recent Harvard Medical School study led by Dr. Jim Hu debating the effectiveness of minimally invasive prostate surgery. Dr. David Samadi, Chief of the Division of Robotics and Minimally Invasive Surgery in the Department of Urology at The Mount Sinai Medical Center in New York, says the lack of surgical volume and experience appears to be the resounding argument from most dissenters. Samadi, along with many other surgeons, believes the study does not present an accurate picture of da Vinci robotic prostatectomy surgery, and expressed concern over such a study being too hastily published without corroboration.

"The consensus is that the study surveyed an older Medicare population, whose ages are prone to incontinence and impotence issues anyway," said Dr. Samadi. "Also, the study did not specify how many of the surgeries were in fact robotic, since it grouped together robotic surgery with manual laparoscopic procedures. These factors alone make the study and its conclusions questionable."

However, the biggest flaw was the time frame of the data collection, which took place from 2003 to 2007, when the system was still new. "Nowadays, there are more experienced surgeons operating with the robot, which has gone through many improvements since its early days," Dr. Samadi reminds readers. "The robot doesn't perform the surgery, the surgeon does, which is why experience counts."

A rudimentary data collection of nearly 7,000 successful robotic prostatectomies contradicts the validity of the study. Robotic surgery experts at Epworth Hospital in Richmond, Australia, Urology Centers of Alabama, Clinic of Urology in Milwaukee and Napa Valley Urology Associates all agree that robotic surgery has consistently demonstrated superior results in prostate cancer cure rates, urinary continence and sexual function. Shorter hospitalizations, decreased blood loss and blood transfusion rates also make this type of treatment superior to traditional procedures. Dr. Samadi, who has performed over 2,100 successful robotic prostatectomies, firmly believes that the pros of robotic surgery far outweigh the cons, which are minimal.

Another argument to note is that the study did not accurately score continence or potency, as most surgeons do in a clinical setting. These issues occur in varying degrees and severities, which is why Dr. Samadi utilizes data from validated patient questionnaires, prior to and consistently after their procedures. "If the problem already existed, then of course it will still exist after the surgery," says Samadi. "Without this data, we can't know how many of these patients had pre-existing sexual or urinary conditions."

The experts, including Dr. Samadi, all concur that robotic surgery has a very large learning curve. Other doctors agree that learning robotics was one of the most difficult techniques to master, which is why the skill of the surgeon is paramount to the procedure itself. The Harvard Medical study did not differentiate among the surgeons and their level of volume and experience, which greatly biased the conclusion.

Finally, the study is in direct opposition to countless other studies that touted the benefits of robotic prostatectomies over any other technique. "When it comes to the trifecta of cancer cure rate, preservation of continence and sexual function, no other technique comes close to delivering the superior results that I've experienced with robotic prostate surgery," concludes Dr. Samadi.

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