How may robotic prostate surgeries have you done?

This is one of the most common questions I am asked.

Patients want to know if their surgeon is qualified to do a procedure.
I always answer this question honestly and to the best of my knowledge. With robotic cases I keep accurate data on outcomes and can answer this precisely.
I then add “How many is enough to know how to do the procedure?”


I explain that I was trained as an open cancer surgeon first and have taken out over 200 prostates. As a resident in Indiana I performed lots of open prostate surgeries, a few laparoscopic prostatectomies, and a lot of laparoscopic nephrectomies.

I knew enough about lap prostates that I couldn’t justify performing lap prostates- my results for continence and erections wouldn’t be as good until I had done 50-100 of them.
Prior to performing a dvP, I already had 4 scheduled. Each man knew we hadn’t done any yet. I knew the operation would be similar or better than open surgery.

Our first guy took 10 hours, but he went home in a day and a half and is now completely continent and has a PSA <0.1 1 year after surgery.

Our 3rd guy took 5 hours, went home the next day, had his catheter out in 6 days and went to work, regained his erections within 2 weeks, and went skiing in 3 weeks.
By the 8th case we were under 4 hours including set up time.

I think somewhere between 20-30 cases I far surpassed what I could do open.
I did my first under 2 hour prostatectomy with pelvic lymph node dissection (of any type) with my 42nd case.

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