In 2002, we raised minimally invasive endoscopic surgery on lithotripsy, prostate and tumor scraping surgery to a higher level – “laparoscopic tumor resection surgery” and “da Vinci prostate surgery,” using our mature skills on various urological tumors such as adrenal tumors, upper urinary tract transitional epithelial cancer, renal cell carcinoma and prostate cancer. Some 100 patients receive different types of laparoscopic surgery here each year, Such methods are as effective as traditional surgery but have the advantage of faster surgery and shorter hospital stay.
Our unique single incision laparoscopic surgery can also be used for adrenalectomy, inguinal hernia repair surgery, varicocele high ligation, among others, providing patients with another option for small wound surgery.
Laparoscopy and da Vinci prostate surgery are the new trend. In the past, a wound was often as big as 20 to 30 cm. Now it is replaced by 3 to 4 small wounds only 1 cm each.
As wounds become smaller, post-surgery pain is much reduced and the patient can go back to routine activities and diet more quickly. With the progress of the image processing system, many small areas can be magnified for viewing, and the surgery can be more precise.
Prostate cancer is unique to elderly men and rarely occurs under the age of 40. Its occurrence increases with age. The rate of occurrence varies greatly around the world, with American blacks and northern Europeans in the high risk group. American Indians and men in the eastern hemisphere are in the lowest risk group. In recent years, however, its incidence in Taiwan is gradually increasing and is about to surpass bladder cancer as the most common male urinary tract cancer. According to Ministry of Health and Welfare (MOHW), the death rate has quadrupled in the most recent seven years.
Prostate cancer can be categorized into latent cancer and clinical cancer. We found that in 25 cases of bladder cancer patients who took prostate palpation, 7 patients (28%) were found with prostate adenocarcinoma. Such percentage of latent cancer is similar to western world, but in terms of clinical cancer, there is 10-20 times of difference between Taiwan and the West. The great difference may be related to genetics, hormonal status and high-fat foods.
We also have excellent results in the treatment of localized prostate cancer. Patients can choose from traditional laparotomy, laparoscopic minimally invasive surgery, da Vince robotic prostate surgery or radiation therapy. We have introduced the newest cryoablation therapy and high-intensity focused ultrasound (HIFU), providing multiple options for patients with prostate cancer.
The postoperative complications for treatment of local prostate cancer include incontinence, sexual dysfunction and wound infection and bleeding. With HIFU and cryotherapy, the incidence of complications is reduced during convalescence. HIFU uses an ultrasound probe and heat to cause rapid solidification and necrosis of tumor tissue. It is less likely to hurt the erectile nerve and can avoid postoperative erectile dysfunction.