Fast forward to Tuesday, and his two incisions to remove a patient’s prostate totaled only about an inch and 2 millimeters, thanks to the latest advancement in laparoscopic surgery at UMass Memorial Medical Center: the Single-Port DaVinci robot.
“It’s really crazy stuff to be honest with you,” Sokoloff said in an interview Tuesday recalling the mantra. He later explained that larger incisions gave a surgeon more space to maneuver and more visibility. “If you told me when I was a resident in the early ’90s this is how you would be doing things, I would have thought you were crazy.”
Sokoloff, chair of the Department of Urology at UMass Memorial, performed the first urological procedure — and the second overall procedure — in Northern New England on Monday using the Single-Port DaVinci. Last week, the robot was used by an ear, nose and throat surgeon at the medical center.
The procedure marked a new era in the treatment of cancer at UMass, as the robot — an enormous presence in the operating room that tapers down to a centimeter-in-diameter port that holds three instruments and one camera — enables Sokoloff and his colleagues to perform minimally invasive prostatectomies (as well as, eventually, removing cancerous bladders and kidneys) using only one or two incisions as opposed to five or six. This mitigates trauma to the patient, improves recovery time and helps improve outcomes, Sokoloff said.
Indeed, he reported that the patient went home Tuesday morning.
“Any area you want to operate on that is really small and tunnellike, and it’s ideal,” Sokoloff said.
But the robot is more than just a “shiny new toy” at the hospital, Sokoloff said. Rather it is a part of the medical center’s focus on optimizing the health of the general population.
Sokoloff explained that prostate cancer is the most common cancer in American men and for about 40% of patients, it needs to be treated with either surgical removal or radiation therapy.
But certain populations are particularly at risk from prostate cancer.
Sokoloff said that African American men and especially African immigrant men have a much higher rate of prostate cancer than other populations, and that these two groups also tend to have more aggressive cancers and be diagnosed and treated when the cancer is at a much more advanced state. In fact, the likelihood of African American and African immigrant men to have prostate cancer, and also die from prostate cancer, is roughly twice the rate of whites, Sokoloff said.
With large numbers of both these at-risk populations, Worcester County has the highest rates of prostate cancer and prostate cancer mortality in the entire state. In fact, Sokoloff said they are almost double the rates in other counties.
“There’s a real challenge to make sure we optimize the treatment of these groups,” Sokoloff said.
So, Sokoloff — who has built the urology department at the hospital over the past even years as its inaugural chair — has attended events at YMCAs, churches and community gatherings to emphasize prostate cancer awareness.
“We always tried to be innovative,” Sokoloff said. “One of the unique attributes of the UMass Memorial system in general is we push new technology, push treatment pathways to further evolve how we treat patients in a good way ... This is the most fun I’ve ever, ever had because these institutions are just so forward-thinking and innovative and collaborative, and they want to push the envelope, and it’s a delight.”
That collaborative approach was apparent while watching the Single-Port DaVinci in action on Monday. As colleagues, medical students and others packed in the operating room observed — and observed in high-definition, full-color detail — as Sokoloff removed the patient’s prostate, a resident had some simple advice.
“Make sure you get your prostate checked,” she said.
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