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Medical Forum / Diseases and Disorders / Prostate Cancer / May 2008

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robotic prostatectomy - how long does it take?

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Dwight - 14 May 2008 03:08 GMT
In general, how long does the robotic procedure take, barring big
problems?

2 hours? 3 hours?

Recovery time - 1 hour?

I'll be having surgery at 1pm tomorrow, and I'm just wondering whether
I'll be able to talk to anyone by phone tomorrow night, to let them
know how I'm doing.
Danger Mouse - 14 May 2008 03:20 GMT
>In general, how long does the robotic procedure take, barring big
>problems?
[quoted text clipped - 6 lines]
>I'll be able to talk to anyone by phone tomorrow night, to let them
>know how I'm doing.

I've read 3 - 4 hours for the operation itself.  Don't know how long it takes
to "wake up".  I'm suspicious you'll be able to do the phone call the same
evening.

I've not been told the time of my operation, but my report time is 10:30, or
actually 10:00 AM at the admissions registration.

My surgery is next Tuesday, same thing, but after rollercoaster riding this
Thursday and the Dayton Hamvention this weekend.  1000 miles round trip from
Virginia.  Should take care of my wanderlust long enough for me to get
recovered to get back on the road in maybe early July... gotta go somewhere...

Hopefully someone that knows can chime in with the "wake up" time.

DM
Danger Mouse - 14 May 2008 03:38 GMT
>>In general, how long does the robotic procedure take, barring big
>>problems?
[quoted text clipped - 8 lines]
>
>I've read 3 - 4 hours for the operation itself.

Ooooopssss.... my bad.  I went back and read it again, and I was reading the
wrong thing on my surgeon's website.  I was reading the one for the regular,
OPEN prostatectomy.  They don't have a guide for the Laproscopic.

A writeup on the laproscopic prostatectomy from the Mayo Clinic:

http://www.mayoclinic.com/health/prostate-cancer/PC99999/PAGE=PC00024

says 2 -  3 hours.

Sorry for the bad info...

Guess that's why I double check stuff.  I can hear my boss saying I should do
that first... <GGG>

And from this totally unrelated, foreign site on anesthesiology:

"The average recovery time was 12±8 minuntes"

at:

http://www.ispub.com/ostia/index.php?xmlFilePath=journals/ija/vol8n2/davinci.xml

That is the Da Vinci system applied to something else, so the anesthesia
protocol is probably similar.  I don't imagine that people who've experienced
the operation would be able to tell any better how long it took them to "wake
up" - just how long the whole operation took.

DM
I.P. Freely - 14 May 2008 04:51 GMT
> Hopefully someone that knows can chime in with the "wake up" time.

Ya first gotta define "wake up". ;-)

I opened my eyes, perceived my surroundings, and began asking questions
a few hours out of the OR. I stayed in that mode most of the night, well
aware that I was getting very little sleep. I was alert enough the next
day to start making some demands out of concern for my recovery. By the
second day post-op I was chatting with the staff, asking questions of
the docs, and understanding medical answers. Remembering any of them was
still inhibited by the narcotics. By about Day 5 or 6 I thought I was
pretty clear-headed, but my wife and brother said I was kidding myself,
that I was still forgetting much of what I was told. Only after the
narcotic were out of my system was I able to make sense of something as
complex as a TV show or magazine article; before that I was living
mostly in the moment without forming solid new detailed memories. The
docs said, "That's narcotics for you." That's also lack of sleep; it
takes several hours of sleep to form good memories, and several
continuous hours of sleep were denied until I had the doctors order the
recovery ward staff to try something new and foreign to them: leave me
the hell alone so I could get some sleep.

Sorry if I sound bitter, but 42 months later, I'm still beyond bitter.
If I hadn't been just awake enough to watch our for myself and hadn't
some family and some concerned surgeons help me, it would have been a
much worse experience.

Tip: if you're alone, you might want to make notes when told anything
important. No matter how clear they seem real-time, details don't stick
well until you kick the narcotics.

I.P.
Danger Mouse - 14 May 2008 10:57 GMT
>> Hopefully someone that knows can chime in with the "wake up" time.
>
[quoted text clipped - 28 lines]
>
>I.P.

I've got this little solid state recorder that I intend to use to record what
they're saying in real time so I can't screw it up while writing it down.  Now,
if I can just remember how to run it when I wake up...

Thanks for the info.  I had no idea how bad it could get.  Dunno if you're on
the "loopy" side of average or not, but now I know how screwed up I _might_ be
and for how long.

I was going to go see Indiana Jones at the flick on Friday after the Tuesday
operation - maybe I'll end up seeing it twice "for the 1st time" 'cuz I won't
remember it the 1st time... <G>

DM
Steve Tew - 14 May 2008 12:38 GMT
> On Tue, 13 May 2008 20:51:37 -0700, "I.P. Freely"
> <fuhgheddaboutit@noway.nohow>
[quoted text clipped - 52 lines]
>
> DM
You may want to reconsider the plan, and determine that you will want to
stay comfortable and relatively immobile for some time after the operation.
Take scheduled walks and gradually increase activity.  I personally would
not recommend going "out" for a while, at least until you are off narcotics.

The consistent tendency of the medical community is to downplay the real
recovery requirements that you may face and "average it up".

I was basically crippled for about a month afterwards.  Short walks
precipitated bleeding and spasms, my abs were so sore that I could not sit
up for weeks without assistance from some sort of rope or other aid.
Sitting for any longer than twenty minutes or so was painful and brought on
more bleeding.  You may feel great for the first few days, but that may be
the pain med that you are on giving you a false sense of well being.  Don't
over do it.

God Bless,
Steve
Danger Mouse - 14 May 2008 18:49 GMT
>> On Tue, 13 May 2008 20:51:37 -0700, "I.P. Freely"
>> <fuhgheddaboutit@noway.nohow>
[quoted text clipped - 54 lines]
>You may want to reconsider the plan, and determine that you will want to
>stay comfortable and relatively immobile for some time after the operation.

Hey, don't ask me - Dr. says he _wants_ me to walk...  but if I don't feel
comfortable as of Friday opening, or that sitting for 2+ hrs would be a trial,
I'll just... stay home!  Only do this stuff 'cuz its pleasant...

>Take scheduled walks and gradually increase activity.  I personally would
>not recommend going "out" for a while, at least until you are off narcotics.

Op is Tuesday, movie is Friday.  See how things are by then...

>The consistent tendency of the medical community is to downplay the real
>recovery requirements that you may face and "average it up".

The doctor's assesment of things does seem to be a bit optimistic when compared
with stuff I read here and elsewhere.  I guess it will be what it wll be.

>I was basically crippled for about a month afterwards.  Short walks
>precipitated bleeding and spasms, my abs were so sore that I could not sit
[quoted text clipped - 3 lines]
>the pain med that you are on giving you a false sense of well being.  Don't
>over do it.

I'm a great one for overdoing things, too...  If I bleed, I stop, tho!

>God Bless,
>Steve

Thanks,

DM
I.P. Freely - 14 May 2008 17:27 GMT
> Dunno if you're on the "loopy" side of average or not

Me neither, but my docs in all my surgeries and procedures involving any
narcotics and my reading all told me it would happen that way: We're
clear-headed in the present but not making sound memories.

> I was going to go see Indiana Jones at the flick on Friday after the Tuesday
> operation - maybe I'll end up seeing it twice "for the 1st time" 'cuz I won't
> remember it the 1st time... <G>

If you're still on narcotics, the problem may be that you will forget
the first half of the movie before you reach the end.

I.P.
Danger Mouse - 14 May 2008 18:52 GMT
>> Dunno if you're on the "loopy" side of average or not
>
>Me neither, but my docs in all my surgeries and procedures involving any
>narcotics and my reading all told me it would happen that way: We're
>clear-headed in the present but not making sound memories.

Sure is great to have this forum.  Thanks a lot for your info.

>> I was going to go see Indiana Jones at the flick on Friday after the Tuesday
>> operation - maybe I'll end up seeing it twice "for the 1st time" 'cuz I won't
>> remember it the 1st time... <G>
>
>If you're still on narcotics, the problem may be that you will forget
>the first half of the movie before you reach the end.

Yeah - if I'm still taking things by mouth at that time that are narcotic in
nature, it might be best to stay home and save the money, and enjoy the
pain-free buzz... <G>

DM

>I.P.
I.P. Freely - 14 May 2008 03:23 GMT
> In general, how long does the robotic procedure take, barring big
> problems?

> I'll be having surgery at 1pm tomorrow, and I'm just wondering whether
> I'll be able to talk to anyone by phone tomorrow night, to let them
> know how I'm doing.

You will have a close friend there most of the time, won't you? I very
highly recommend a pair of sharp ears connected to a clear mind as long
as you're on any narcotics; otherwise you won't remember your
doc's/nurses' instructions and there'll be no one to there to make sure
they don't give you the meds intended for the menopausal female
manic-depressive kidney transplant patient in the next room.

I.P.
Dwight - 14 May 2008 05:43 GMT
> > In general, how long does the robotic procedure take, barring big
> > problems?
[quoted text clipped - 3 lines]
>
> You will have a close friend there most of the time, won't you?

Some of the time anyway.  Not sure about overnight.

Where did you have your surgery done?
I.P. Freely - 14 May 2008 06:25 GMT
>>> In general, how long does the robotic procedure take, barring big
>>> problems?
[quoted text clipped - 6 lines]
>
> Where did you have your surgery done?

In the Seattle VA by University of Washington teaching hospital surgical
oncologists/med school professors who performed surgery very often. The
recovery ward, however, was pure VA. My family couldn't stay overnight
(I wouldn't have wished that on them anyway), but were there during the
docs' morning and evening rounds and much of the day.

I.P.
J. Veil - 14 May 2008 03:43 GMT
I had my operation in January 2008.
Was wheeled in to surgery 8am and regained consciousness at 4pm. Doc said
the actual op took four hours.
Good luck with your operation and wish you a good outcome and speedy
recovery.

John
==============================
> In general, how long does the robotic procedure take, barring big
> problems?
[quoted text clipped - 6 lines]
> I'll be able to talk to anyone by phone tomorrow night, to let them
> know how I'm doing.
John - 14 May 2008 12:46 GMT
> In general, how long does the robotic procedure take, barring big
> problems?
[quoted text clipped - 6 lines]
> I'll be able to talk to anyone by phone tomorrow night, to let them
> know how I'm doing.

I'll be thinking about you Dwight. I hope everything goes well.

John
Dwight - 14 May 2008 15:51 GMT
> > In general, how long does the robotic procedure take, barring big
> > problems?
[quoted text clipped - 10 lines]
>
> John

Thanks John.  5 hours and counting.
jloomis - 15 May 2008 03:29 GMT
Hi Dwight,
I am sure all will go well.
Look at the bright side.....It will all be over tomorrow......
I promised myself the view of the hospital from the rear view mirror.....
I got it.....That was the best view of the hospital I had......
Good wishes, and speedy recovery.
Look forward to that view.......from the rear view mirror.....
jloomis
On May 14, 4:46 am, John <jcarne...@verizon.net> wrote:
> On May 13, 10:08 pm, Dwight <nodamnspa...@yahoo.com> wrote:
>
[quoted text clipped - 12 lines]
>
> John

Thanks John.  5 hours and counting.
Steve Tew - 14 May 2008 12:48 GMT
> In general, how long does the robotic procedure take, barring big
> problems?
[quoted text clipped - 6 lines]
> I'll be able to talk to anyone by phone tomorrow night, to let them
> know how I'm doing.

I relate some personal details in this post from Saturday, September 22,
2007 5:41 PM:  My operation was on Sep 18...

I am pretty comfortable today and making great progress.  The last few days
are somewhat of a fog, and a mix of good and bad memories.

Here are some rambling thoughts on some of my experience.  Most of this is
fairly fresh in what little memory I have and might fill in some of the
murkier expectations of anyone who is headed for surgery.

The Surgery took place on Tuesday.  Started at 9:30am. Finished about
2:00pm.

I woke up in recovery and saw a large clock hanging from the ceiling,
reading 2:30.  My recovery nurse was really nice.  She is a cook and says
that her ribs are the best around.  We swapped recipes and so forth until
about 3:30 when they took me up to my room.  I don't remember the recipes or
her name, but she was very pleasant to have around...

I spent two nights in the room; pain was pronounced enough to keep me from
sleeping on Tuesday night.  I had a sleeping pill on Wednesday night...
That was a real treat since I was so exhausted.  Violet stayed in the room
with me.  She was sleeping on the roll - around when the nurse came in at Oh
dark thirty to get vitals on Wednesday night.  I was wearing my headphones
and apparently could not hear him call my name.  Violet says he became very
concerned very quickly.  He thought I was unresponsive for some other
reason, like death, maybe.  We had a little chuckle over it.

The doc didn't want me walking on Tuesday.  Bed rest.  Wednesday I took my
first walk about noon.  Sat in a chair for a while.  Took another walk.
Then another.  Then crashed hard with extreme pain.  The evening nurse
firmly but kindly lectured me on over doing it.

I developed gas over the two days in the hospital and continued to be a
painful problem until Friday.  Changing pain indicators and sites throughout
the stay made it difficult for me to make the call as to "pain level" and
what I thought was the cause...  The intestinal distension was masking some
of the surgical pain, I think, and there was a specific place in the right
abdomen under the drain which was really sore.  The combination of percocet
and morphine did abate the intensity of that particular pain as long as I
did not move.  Movement fired it up (as well as the other site - specific
pain, but that was not as pronounced by a long shot) to the point where I
was getting very concerned that something was wrong.

I saw a number of doctors over the period, and each pronounced that I was in
really good shape and that the surgery went perfectly.  I was having some
doubt though, until Wednesday evening when I was able to articulate exactly
what was going on with the pain to my nurse and doctor, and was reassured
that the sort of migratory, transitional, intermittent, constant localized,
gassy, bloated pain was perfectly normal for my situation.  It seems to me
that there is a tendency to gloss over some of the expectations when
discussing the aftermath of surgery with the patient, because of the
subjective nature of the issue.  Basically, no matter how crappy you feel,
or how unique your situation seems to you, it is probably familiar to the
doctors and nurses, but you don't know that, and they cannot tell what is
really going on if you cannot clearly express it.  This is a problem
considering you are distracted by pain, exhausted, and stoned.

I couldn't believe the amount of gas I was producing in the bowel.  The doc
said that the body absorbs the carbon dioxide they inflate the abdomen with
when working.  That it is released back through the gut.  No fun at all.
Note that the conventional pain killers do not help reduce the pain of
abdominal wall distension or bladder seizures, although enough oxycontin and
morphine will cause you to not care too much about it.

In discussing the particular pain in the right side that was a concern, the
doctor said that it could be caused by bladder spasm and that I could have
an anti -spasm drug to take care of it.  Well, I was due for a couple of
hits of oxy and they were willing to give me another morphine shot at the
time, so the discussion turned to the question of whether I should do one or
the other of these drugs.  The reason presented by the doc (all of these
references are generic in the sense that unless I say Dr Koeneman I am
talking about either the floor resident or the fellow who was working under
Koeneman ) was that they would not know which one was helping if I just took
them all at once.  After the fact, Violet and I were laughing about it,
because, in reality, who gives a rat's a.s which one helps as long as it
works...

The pain management program in this case was based on the patient asking for
meds.  Instead of scheduling the meds for specific intervals they waited
until I told them that I wanted pain medication.  So, there were a few times
where the delay between the call for meds and the delivery was over thirty
minutes.  One time was over an hour.  When entering the room, they asked me
about  my pain, and I told them what seemed right at the time.  I would have
specifically requested the meds get scheduled, which we did do the second
day when one of the nursed actually recommended it, if I had known how it
worked at the outset.  The nurses were quite good to me and there were a
couple who were super - duper nurses.  They did their best to keep me
comfortable in every way as far as I could tell, but they had this
procedural glitch in pain management.  So, it would be a good idea to tell
them straight out that you want the meds on the most effective schedule
right off the bat, and if you are doing really well, taper off.

More to come.

God Bless,

Steve

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