Q. What type of training did you have to perform robotic prostatectomy?

A. Because robotic prostatectomy was first described in 2001, many surgeons have learned this technique by observing and/or being proctored by other surgeons with more experience using the robot.  Dr. Hu was fellowship trained at City of Hope Cancer Center, which Businessweek cited as one the leading centers for robotic prostatectomy in 2004. He performed approximately 300 robotic prostatectomies and 10 robotic cystoprostatectomies for bladder cancer during his fellowship. Furthermore, Dr. Hu was a visiting lecturer in Taiwan where he demonstrated robotic prostatectomy and laparoscopic radical prostatectomy to Taiwanese urologists at Triservices General Hospital, MacKay Memorial Hospital, and Taipei City Hospital.

Q. How many robotic prostatectomies have you performed?

A. A study performed by Dr. Hu showed that for open radical prostatectomy, surgeons performing less than 40 open prostatectomies a year had a complication rate 2 times greater than surgeons performing more than 40 prostatectomies a year. In addition, another study recently showed that after radical prostatectomy, prostate cancer is less likely to recur in hospitals performing a high volume of surgeries. While Dr. Hu and others are presently gathering data to answer this question for robotic assisted laparoscopic radical prostatectomy, another study showed more than 250 cases were necessary just to overcome the learning curve of using the robot.

During Dr. Hu's fellowship, he was involved in the preop, intraop, and postoperative care of over 300 men undergoing robotic prostatectomy. In addition, Dr. Hu has proctored surgeons learning robotic assisted laparoscopic radical prostatectomy in California and Massachusetts. Dr. Hu has published several papers describing consistent anatomic landmarks for nerve-sparing and a technique to simplify the reconstructive stage of a robotic prostatectomy. Finally, Dr. Hu has performed over 550 robotic prostatectomies in Boston over the last 3 years.

Q. How do you track your outcomes in terms of continence and potency?

A. Patients commonly ask urologists what their risks of incontinence and impotence are following surgery. A study by Dr. Litwin showed that continence and potency rates reported by health care providers differ from that obtained from validated instruments such as the UCLA Prostate Cancer Index or the Expanded Prostate Cancer Index Composite. Furthermore, a recent papers by Dr. Spencer and Dr. Miller suggest that measuring continence and potency following treatment for prostate cancer with validated quality of life instruments are indicators of quality of care.

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