For men, prostate cancer is the second most common form of cancer in the United States.

Sixteen percent of American men will be diagnosed with the disease at some point in their lifetime, and many of those will require surgery, according to the American Cancer Society.

West Virginia University Hospital now has a new tool in its arsenal to fight the disease, a surgical robot officials say offers patients advantages over and better results than traditional surgery.

Instead of one large incision, the robot, called the da Vinci, uses several tiny openings, cameras and three-dimensional imaging to make the surgery “more precise,” according to hospital officials. But Dr. Hesam Mohseni, associate professor of urology at WVU’s medical school, says it still takes a skilled surgeon to operate the machine.

“This is not any deviation from the standard surgery. We are doing the same surgery, just using different instruments. … There’s no violation of the surgical principle,” he said.

And the robot is always under his full control.

“When I take my face off the machine, the machine stops working,” Mohseni said.

“There are requirements to becoming a robotic surgeon, just like getting your pilots license,” Dr. David McFadden, chief of surgery at WVU, said. “Only when they feel that the surgeon has passed do they sign off and he or she’s given hospital privileges.”

Mohseni underwent extensive training before performing the procedure on a real patient for the first time May 1.

“I did go to a course. I did work on pigs for a couple days, and then I went and observed the surgeons who were doing it at other institutions. Then the first few cases we did, we had proctors come and observe us and give us direction on how to do it,” Mohseni said.

The first patient to be operated on with the da Vinci robot was happy with the procedure, according to Mohseni. He went home the next day.

“The first time I did it, I told the patient I did this surgery many times through open surgery. I’ve never done it through this approach. I’d appreciate it if you’d let me do it, and he said, ‘Sure.’ I said these are the risks and I want you to know I’ve never done it before and this is the first one I’m doing,” Mohseni said.

Considered by many urologists to be less invasive, Mohseni said the da Vinci system offers patients advantages over traditional open surgery, like sparing the nerves controlling erection and urinary control. He said the result is that a higher percentage of patients tend to retain control of those functions after surgery.

The doctors also said most prostate surgery patients won’t need a blood transfusion if the da Vinci is used.

“Radical prostatectomy (removal of the entire prostate gland) is generally a very bloody operation. You can lose a lot of blood. But the blood loss is extremely low in this type of operation, because you can see the blood vessels so well,” Mohseni said.

The robot’s “arms,” four in all (though Mohseni says they normally use only three) can take a variety of tools and can hold steady, even if a surgeon’s hands shake while operating it. They offer more exacting control over incisions and a much greater range of motion, the doctors said.

“These robotic appendages have more degrees of freedom than your fingers,” McFadden said. “You can’t move your wrists 360 degrees.”

The surgeon sits at a console about 10 feet away from the surgical table at station with a view finder and special control arms. The surgical team, at a minimum, always includes a specially trained anesthesiologist and robotic surgery nurse to assist. From the station, the doctor can speak to the team and vice versa.

“It has a microphone here, so (the surgical team) can hear everything you say, so you have to be very careful what you say,” Mohseni said with a smile. “Even if I whisper, they can hear me.”

Jesse Hixson, one of the hospital’s robotic surgery nurses, is responsible for changing the various tools the robot’s arms can hold during surgery. He said the team can view the surgery on large monitors and that every procedure is recorded.

“That’s important,” he said. “Because it can be used for teaching other people later.”

McFadden says that in some cases, surgeons have operated on patients using the robots remotely with a satellite linkup.

“Not that we’re doing that here,” he said. “We tend to keep our patients about eight to 10 feet from the surgeon.”

For more information about the da Vinci system and the prostate procedure, go to

E-mail Justin McLaughlin at

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