Single Port Robotic Surgery

Dr. Daniel Park from USC Keck Medical Center presents a comprehensive overview of prostate cancer diagnosis, treatment options, and cutting-edge surgical techniques.

This presentation offers invaluable insights for newly diagnosed patients, those considering treatment options, and anyone interested in the latest advances in prostate cancer care. Dr. Park combines deep technical expertise with an approachable, patient-centered perspective.

KEY TOPICS COVERED:* Diagnosis & Detection:

• PSA testing limitations and the continued importance of digital rectal exams

• The game-changing role of MRI in prostate cancer detection

• MRI fusion biopsies vs. traditional random biopsies - how many cancers are missed

• Gleason scoring (Grade Groups 1-5) and what the numbers mean

• Why traditional biopsies are imperfect and often miss aggressive cancers

Treatment Options: Dr. Park reviews the full spectrum of treatments including surgery, radiation, active surveillance, hormone therapy, and focal therapy. He emphasizes the treatment "trifecta" goals: cancer control, urinary continence, and erectile function preservation. Active Surveillance:

• Appropriate for low-risk Gleason 6 (Grade Group 1) disease

• Not "watchful waiting" - requires regular PSA, MRI, and biopsy monitoring

• When to convert to active treatment

Robotic Surgery Revolution: Extensive discussion of USC's single-port robotic surgery platform:

• Evolution from open surgery to minimally invasive techniques

• Single-port advantages: ~3cm incision, faster recovery, improved precision

• Superior visualization and triangulation compared to traditional laparoscopy

• Minimal scarring and quicker return to normal activities

• USC's investment in cutting-edge surgical technology

Focal Therapy - HIFU (High-Intensity Focused Ultrasound): Detailed explanation of this prostate-sparing treatment option:

• How HIFU works: focused ultrasound energy heats tissue to ~194°F with millimeter precision

• Two machines at USC: Sonicare and Ablotherm

• Procedure takes 2-3 hours with real-time monitoring

• Success rate: 80-85% based on USC's published research

• Patient selection criteria: localized disease (T1-T2), Gleason 6-7, appropriate prostate size

• Who should NOT have HIFU: advanced disease, high-grade cancer, certain medical conditions

• Critical importance of post-treatment surveillance (annual MRIs, periodic biopsies)

Emerging Technologies:

• AI applications in surgical training and cancer detection

• PSMA PET scans as next-generation imaging

• Clinical trials: aquablation, nanopac injections, vaccine research

• Future of robotic and AI-assisted surgery

Q&A HIGHLIGHTS: Viewers ask about:

• HIFU success rates and patient selection (honest discussion about 15-20% recurrence rates)

• Managing PSA recurrence after prostatectomy (salvage radiation options, PSMA PET imaging)

• AI's role in prostate cancer diagnosis and treatment

• Post-HIFU follow-up protocols and aquablation for BPH symptoms

• Active surveillance for newly diagnosed patients with pre-existing bladder issues

• USC's focal therapy specialists: Dr. Andre Brew and Dr. Amir Lebashti

• Insurance considerations and choosing high-volume treatment centers

• Advanced treatments for metastatic disease showing improved survival rates

KEY TAKEAWAYS:

• MRI is essential for accurate diagnosis and treatment planning

• Not all prostate cancers require immediate aggressive treatment

• Multiple effective treatment options exist - choose based on individual circumstances

• High-volume centers like USC offer latest technologies and expertise

• Post-treatment surveillance is critical regardless of treatment choice

• Support groups and patient education are vital - men need to talk about their health