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Mooshee.com - Performing less invasive laparoscopic surgery using robotic 
technology may improve survival rates for prostate cancer patients, 
according to a study by urologic oncologists at Thomas Jefferson University 
Hospital's multidisciplinary Genitourinary (GU) cancer center.

In a study presented May 21, 2007 at the annual American Urological Society 
meeting in Anaheim, Calif., the Jefferson urologists found that performing a 
laparoscopic radical prostatectomy (LRP) with robot technology can reduce 
positive surgical margins. Positive surgical margins refers to when cancer, 
seen under a microscope, goes to the edge of a specimen, meaning that 
cancerous cells likely remain in the patient. LRP is the surgical removal of 
the entire prostate gland and surrounding tissue including the seminal 
vessels through several tiny incisions.

"We demonstrated a significant improvement in the positive surgical margin 
rate with the addition of robotics to an established LRP," said Costas 
Lallas, M.D., assistant professor of Urology, Jefferson Medical College of 
Thomas Jefferson University, one of the investigators. Dr. Lallas completed 
a robotic surgery fellowship at the Mayo Clinic.

"Several large studies have demonstrated that a positive surgical margin 
increases the chances that the prostate-specific antigen (PSA)- a protein 
produced by the cells of the prostate gland - will rise after surgery, and 
increase the chances that the disease will reoccur and progress," said 
Edouard Trabulsi, M.D., assistant professor of Urology, Jefferson, a 
urologic oncologist and an expert trained in laparoscopic prostatectomy by 
one of the pioneers of the technique. "Therefore,
any intervention or technique to lower positive surgical margins, we think, 
will translate into a better long-term cure rate."

The study demonstrates that even in a high volume center with an established 
laparoscopic radical prostatectomy program, which has been in place at 
Jefferson since 2000, the addition of robotic technology leads to a lower 
positive surgical margin rate, the researchers said. The Jefferson 
urologists reviewed the cases of 247 men with clinically localized prostate 
cancer treated at Thomas Jefferson University Hospital with either LRP or 
robotic assisted laparoscopic prostatectomy (RALP) from March 2000 to August 
2006. Of the 247 cases, 197 patients underwent LRP and 50 patients underwent 
robotic assisted laparoscopic prostatectomy... Cont.

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