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| THE
A.R.T. OF PROSTATE CANCER SURGERY |
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| WHAT
IS THE AUSTIN ROBOTIC
TECHNIQUE? |
| The Austin
Robotic Technique was
developed by Dr. Randy Fagin to bring his patients the
highest likelihood of attaining the “trifecta”
of prostate cancer surgical outcomes: free of cancer,
free of urinary leakage, and erections capable of intercourse.
Dr. Fagin has traveled the world to learn from the International
leaders in laparoscopic and daVinci robotic prostate surgery.
He has tracked his own patient outcomes and integrated
the most effective and advanced techniques with a urinary
and erectile rehabilitation program to develop the Austin
Robotic Technique. Dr.
Fagin’s daVinci A.R.T. procedure
helps patients maximize their ability to reach this “trifecta”
by combining: |
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the
most sophisticated surgical technology of daVinci
robotics |
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innovative and advanced surgical techniques for
extended erectile nerve sparing and urinary muscle
preservation |
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a
comprehensive program of urinary muscle and erectile
rehabilitation |
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| What
follows is an explanation of each portion of this technique. |
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| PRESERVATION
OF URINARY CONTROL |
| Recovery
of urinary control is dependent on many factors.
Some of these factors are out of Dr. Fagin’s
control like a patient’s other medical conditions
and the thickness and strength of their bladder
neck. Other factors are under Dr. Fagin’s
control, like the amount of bladder neck musculature
that is spared, avoiding thermal injury to the pelvic
floor muscle fibers, and the length of urethra that
is able to be preserved. Your prostate ultrasound
pictures play an important role as they allow Dr.
Fagin to create a pre-operative blueprint of how
he is going to approach your bladder neck and urethra.
Having this blueprint lets him to plan out and contour
his surgical movements so as to preserve the most
bladder neck muscle possible, minimize manipulation
and avoid thermal injury to the delicate pelvic
floor muscles, and maximize the length of urethra
he is able to preserve. |
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| EXTENDED
NERVE SPARING |
| Dr. Patrick Walsh from
Johns Hopkins first described the location of the
nerves adjacent to the bottom portion of the prostate
that are critical to men’s erectile function.
Since the publication of this landmark study other
data has emerged from Dr. Mani Menon detailing the
location of additional nerve fibers present in the
tissue extending up the sides of the prostate gland.
Preservation of these additional nerve fibers has
produced outcomes that exceed
the standard nerve sparing technique in his hands.
Dr. Fagin has spent time learning this technique
from Dr. Menon and uses this innovative and advanced
technique as a part of the A.R.T.
procedure. With this technique Dr. Fagin has seen
a significant improvement in short term erectile
function recovery. Dr. Fagin expects with the improved
short term outcomes he is seeing on this extended
nerve sparing technique that the long term outcomes
will be improved as well. |
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| URINARY
AND SEXUAL REHABILITATION
PROGRAMS |
| Dr.
Fagin has created a detailed program of pre surgical
preparation and post operative rehabilitation to
maximize his patient’s ability to return to
their pre surgery level of urinary and sexual function
as rapidly as possible. Dr. Fagin created this program
based on international data in the fields of urinary
and sexual rehabilitation. This formalized rehab
program works to maximize tissue oxygenation, and
muscle strengthening while reducing the likelihood
of scarring that can slow or prevent full recovery.
Although not all patients will return to their pre
surgical level of urinary and sexual function, Dr.
Fagin’s rehab regimen helps patients to improve
their chances of reaching that endpoint and is an
integral part of his A.R.T. protocol.
The details of these rehabilitation programs can
be found in the later sections of this packet. |
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