DaVinci Robot

*Dr. McGinnis, and Dr. Ilia Zeltser
Bryn Mawr Urology specializes in the world's most state-of-the-art treatments of prostate cancer utilizing the da Vinci robotic surgical system which facilitates Laproscopic Prostatectomy.

*Dr. McGinnis received his bachelors degree, cum laude, from Harvard College, Cambridge, Massashusetts and his medical degree from the University of Texas Health Science Center at San Antonio, Texas. He studied laparoscopic radical prostatectomy and was taught by the Originators of Laparoscopic Prostate Surgery at the Institute Mutualiste Montsouris in Paris, France. Dr. McGinnis served both his general surgery and urology residencies at Thomas Jefferson University Hospital, in Philadelphia, Pennsylvania and was among the first urologists in the United States to perform laparoscopic radical prostatectomy in Pennsylvania.

Dr. McGinnis is a nationally recognized expert in the field. He has been featured on ABC News, and PR Newswire. Dr. McGinnis is one of the founders of Robotic Surgery in Pennsylvania. Patients travel from across the United States to have Dr. McGinnis perform their Laparoscopic Prostate Surgery. Please contact the office to make an appointment.

Ilia S. Zeltser, MD , Urologic Surgeon at Bryn Mawr Hospital, is among an elite group of physicians nationwide and the only in the Philadelphia region performing laparoscopic Retroperitoneal Lymph Node Dissection, a safe and effective way to treat testicular cancer, as well as help establish its exact stage and type, with less pain and faster recovery when compared to traditional surgical procedures.

Urologist Dr. David McGinnis now offers a new, minimally invasive surgical procedure for the treatment of prostate cancer using a computer-assisted surgical system, called da Vinci Prostatectomy. This system provides enhanced visualization and surgical precision, resulting in further improvement in outcomes as compared to standard surgery. U.S. surgeons used the da Vinci System to perform 2,700 prostate cancer operations in 2004.

For many patients approaching surgery, it is often difficult to visualize what is entailed in a specific surgical procedure. To give prospective da Vinci Prostatectomy patients a better understanding of the advances made by robotically-assisted minimally invasive surgery watch the Da Vinci prostatectomy Video which shows a three-dimensional simulation of the male reproductive anatomy, the robot technology and the procedure itself.

According to Dr. McGinnis, a current standard treatment for prostate cancer is open radical prostatectomy, in which a five inch incision is made in the patient’s lower abdomen to remove the prostate. “The clear advantages of performing this procedure laparoscopically are decreased pain, quicker recovery and less bleeding,” he explained. “The future of surgery is to become less invasive and limit the side-effects of treatment, and this is a big step in that direction.”

Dr. McGinnis uses a robotic arms to perform surgery while looking at an image magnified thirty-five times. With this method, he has greater control over the instruments and gain a sharper ability to identify areas where the cancer may have spread.

Recent studies suggest that da Vinci Prostatectomy may improve cancer control and reduce the risk of urinary incontinence and impotence following surgery. For most patients, da Vinci Prostatectomy offers numerous potential benefits over open prostatectomy including:

• Shorter hospital stay (generally overnight)
• Reduced postoperative pain and discomfort
• Less risk of infection
• Less intraoperative blood loss and need for blood transfusion
• Less scarring
• Faster recovery
• Quicker return to normal activities and return to work
• Smaller surgical incisions (one inch or less) with improved appearance
• Shorter catheter duration (five to seven days)
• Earlier restoration of urinary continence and erectile function

DaVinci Prostatectomy Patient Education

Why Choose the da Vinci Prostatectomy? You are cordially invited to call us and learn about treatment options for prostate cancer, including the latest minimally invasive treatment Da Vinci Robotic Prostatectomy. Please Call Bryn Mawr Urology 610.525.6580

Frequently Asked Questions

Q: Am I a candidate for robotic prostatectomy?

A: If you are a candidate for conventional and have not had previous pelvic radiation and have not had multiple abdominal surgeries then we would like the opportunity to present you with some of the potential benefits of the robotic option.

Q: Does my insurance pay for robotic surgery?

A: The majority of insurance companies pay for robotic surgery as they would laparascopic surgery however there are exceptions.  Please consult with your carrier to confirm.

Q: Does the robotic prostatectomy remove cancer as well as conventional surgery?
A: Conventional surgery results in very high cancer cure rates.  In the hands of an experienced surgeon like Dr. McGinnis, cancer cure rates are at least as good as conventional surgery, if not better.

Q: How long does the operation take?
A: Barring unusual circumstances, plan for the actual procedure to take 3 - 4 hours.

Q: What happens during surgery?
A: During the surgery, you will be given general anesthesia.
The dVP is performed through 5 to 6 small incisions across the mid abdomen. Through these small incisions, fine laparoscopic instruments are inserted to dissect the prostate gland, seminal vesicles, and vasa deferentia from the urethra and bladder.
Excellent visualization of the prostate gland and the surrounding neurovascular structures is achieved with the use of a high-powered telescopic lens attached to a camera device. Once the prostate gland is dissected free from the bladder, rectum, and urethra, it is placed in a small plastic bag and eventually removed by extending one of the small incisions to accommodate the prostate. The bladder is sewn back to the urethra to restore continuity of the urinary tract.
A catheter is placed through the penis to drain the bladder and allow healing of the bladder-urethra connection. In addition, a small drain is placed near the surgical site. Pre-Operative Routine pre-operative testing is performed prior to surgery.
A clear liquid diet is started the day prior to surgery. To help evacuate any contents in the bowel, patients are instructed to drink one bottle of magnesium citrate on the evening before surgery and administer a Fleet enema the morning of surgery. Patients should receive nothing by mouth for at least six hours prior to surgery.

Q: Will I need to donate my own blood to have on hand during surgery if the need for a transfusion arises?
A: One of the many benefits of the surgery is minimal loss of blood. Therefore, it is not necessary to have your blood available for transfusion.

Q: Will this operation render me sterile?
A: Yes, all patients undergoing radical prostatectomy will be rendered sterile (i.e., will not be able to father children) after the procedure.

Post-Operative Care

Q: How long can I expect to stay in the hospital after the procedure?
A: Hospital stay for most patients is 1 day.

Q: After the surgery, when will I be able to resume normal activities?
A: The major advantages of the surgery is decreased bleeding and decreased pain which results in easier recuperation. Thus, most individuals undergoing this operation will be able to resume normal activities within a few days of surgery. However, each individual heals at his own rate. You should listen to your body, and do what it tells you do to

.Q: After the surgery, when will I have complete urinary control?
A: Internally, the same operation is done with robotic or conventional surgery. With conventional surgery, 50 percent of patients will have full urinary control – that is, wear no pads – within 3 to 6 months following surgery. Ninety-five percent will achieve this within one year.

Q: Will I be able to have normal sexual relations immediately after surgery?
A: No. Even when the nerves are preserved, it takes time for them to heal and function. With conventional surgery, if you are below 60 years of age and had normal sexual function (Sexual Health Inventory for Men Score of 25), there is an 80 percent chance that you will be able to resume sexual intercourse within 12 months. Statistics indicate that, with robotic surgery, one-third of patients that fit this criteria resume sexual intercourse within 12 weeks of surgery. This is much quicker than with conventional surgery, but we do not anticipate that the long-term outcome will be different. Many individual patient characteristics influence sexual function outcomes.

Q: How long can I expect to be off of work after the procedure?
A: You will be given two weeks’ disability after the surgery. Long-term disability is not necessary after this procedure since complications are rare. Any further time off will be given only if medically necessary. Additional disability will be determined on a case-by-case basis.

Q: What about Post Operative Pain?
A: Because dVP performed through very small incisions ,it is associates with little surgical pain. Most patients recover without narcotics. The reduction of pain also permits most patients to get back on their feet within hours of surgery and leave the hospital sooner.

Bladder Spasms: Bladder Spasms are commonly experienced following prostatectomy as a moderate a cramping sensation in the lower abdomen or bladder. These spasms often decrease over time. 

Urinary Catheter: A urinary catheter is used to drain the bladder for approximately 5-7 days following the surgery. It is not uncommon to have blood-tinged urine for a few days to a week.

Pelvic Drain: The pelvic drain is placed in the operating room to drain the pelvic space around the bladder-urethra. It is usually removed in 24 hours.

Diet: Most patients are able to tolerate clear liquids a few hours after surgery and a regular diet the following day. Liberal fluid intake is encouraged.

Fatigue: Generalized fatigue is common and should start to subside in a few weeks.

Constipation: Sluggish bowels for several days to a week following surgery can occur. Suppositories and stool softeners can be used.

Showering: Wound sites can get wet, but must be patted dry. Showers are permisable but tub baths are not recommended in the first 2 weeks following surgery.

Activity: Walking is strongly advised. Prolonged sitting or lying in bed should be avoided.. Climbing stairs should be limited. Driving should be avoided for at least 1 week. Most patients return to full activity an average of 2 weeks after surgery.

Medications: With the exception of aspirin or other blood thinners, usual medications can be resumed following surgery.