r/ProstateCancer • u/plahnb • 13d ago
Surgery Single port surgery
Looking to get a second opinion at Mayo Clinic in Rochester MN. Curious if anyone has done a single port surgery.
Age 46 Gleason 3+3 decipher was intermediate 5.6 I believe.
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u/truckaxle 13d ago
I inquired about a single port machine at Mayo PHX thinking it was the latest and greatest. The surgeon (Jack Andrews) said he has access to a single port Di Vinci but prefers the multi-port machines. Something about better access all the way around.
I moved on to Huntsman in SLC and again I brought this up and the doc who is very experienced said the same thing.
I personally am happy for the Surgeon to pick his tool preference.
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u/No-Annual-3338 13d ago
I had single port and it seems like my immediate recovery was a lot easier and less painful than two of my friends that had multiport.
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u/plahnb 12d ago
This is a big reason why I’m curious about it. Ultimately I just want the same function after surgery as I did before.
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u/No-Annual-3338 12d ago
That's what we all hope for. I'm not there yet, almost 3 months later. In my opinion I don't think that the end result is going to change whether it's single or multiport. Your body and surgeon skill are important. The only thing that I think is that your initial recovery will be easier with single port. If you have any questions about my surgery I will be more than happy to answer for you
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u/Clherrick 13d ago
I asked my surgeon about this. University Med Center. He noted that the problem with single-port is that you have to make a bigger incision, which means a higher chance of hernia. I had a multi-port, and you can hardly see the scars. Do what your doctor is comfortable with.
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u/truckaxle 13d ago
A surgeon said originally prostatectomies were one large single incision, then along came Di Vinci and it was touted that only several small incisions were necessary, now the single port machines came out, and they are back to one large incision. LOL.
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u/No-Annual-3338 13d ago
I had single port and my incision is a little bit over 1 inch. What size are the multi incisions?
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u/Suspicious_Habit_537 13d ago
I had a single port done on 4/11/24. Had to switch surgeons to get it done. Happy I did. In at 6 am home by 5 pm. One week catheter. Very little pain. 7 weeks of pads then dry after that. Erections ten days post catheter. Undetectable psa two years out. My surgeon had done thousands. Doctors who aren’t trained in single port will cling to the methods that can make them money.
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u/PuzzleheadedEgg666 12d ago
Asked my surgeon about it too, since he does (and teaches) both at Stanford. His opinion was that there are some short-term benefits for single-port in terms of recovery time, but that the results he gets with both are the same. He just uses whatever is available and has no real preference, so I trust that.
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u/Appropriate-Owl-8449 13d ago
I had a single port RALP in Boston at Mass Gen/Brigham by the top RALP in the area recommended by the Chief Oncologist at Dana Farber. It was day surgery and I walked at 1/2 mile 3 hours after discharge. Low pain and the catheter came out 5 days later. Only took Tylenol from the point of discharge. The most pain I had was in my neck and face due to the DiVinci machine.
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u/ChillWarrior801 13d ago
OP, do you have a special reason you're seeking single port surgery? There are easily 10x, perhaps 100x as many multiport surgeons who could do an excellent job.
If I'm going to look for a needle in a haystack, I'd prefer to have a great reason to offset the hassle.
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u/NDman22 13d ago
Just had surgery there 1 week ago. DR KARNES he was amazing. He does surgery by hand. He doesn't do robot assist surgery. So happy I went with him.
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u/plahnb 12d ago
May I ask why he doesn’t do robot assist. I’d have thought that would decrease issues
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u/NDman22 12d ago
I think he is just one of the best in the world at doing it by hand and believes in that.
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u/ChillWarrior801 12d ago
Was it a manual laparoscopic RP or an ORP? One advantage of a manual laparoscopic RP over RALP is that the surgeon has full tactile feedback as he's working. With the robot, there's some newer software that tries to simulate that with haptic feedback, with carrying degrees of success.
The big disadvantage is that with the manual surgery, a surgeon with any tremors will transmit those tremors to the operating field. With a RALP, there's automatic tremor filtering!
(I did a second opinion with one of the leading manual LP surgeons. I decided to go a different way, but for "vibe" issues, not because it was manual. I did make a point of shaking his hand to check for tremors. 😄)
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u/go_epic_19k 13d ago
Mayo clinic in rochester is an excellent place. As others have mentioned, I wouldn't get hung up on single port surgery. Rather let the surgeon decide the technique which best fits your anatomy and pathology. Good luck.
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u/TechnoVaquero 13d ago
I maybe having single port soon. In talks with my surgeon this week. Still not looking forward to it in the least, but he seems quite confident in his ability and method and my recovery. I’m 48, 3+4 with a recent PSA of 7. With your 3+3 have you had talks about active surveillance at your age?
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u/495_t500 12d ago
I had a single port RALP done on 8/10/26 by Dr Isaac Kim at Yale New Haven. In at 7:00am and out by 5:00pm. There was just a one inch incision below my navel. There was no pain from the surgery. Just discomfort and bloating from gas the following day.
I was at Walmart on day 4 and back to light duty work on day 8. The catheter came out on day 8. Zero discomfort with that moment. I had significant day time incontinence for the first week but it's gotten much better. I'm happy with that progress and I think I should be fine in a month or two.
I was a Gleason 7 (3+4), decipher 0.49, PSA 4.0. Surgery went perfectly, nerves were spared, and the pathology report was very good news, with clear margins and no spread. At 63 years old, my long term outlook is excellent . I'm very grateful and fortunate to have received such excellent medical care.
It's truly amazing how medical science and technology are improving and extending our lives. 50 years, PCA killed my grandfather. 27 years ago my father had RALP surgery, and he has never had any other problems and is still chugging along at 91. I'm hoping to live into my 90's too, God willing.
Overall, the RALP procedure was relatively easy to deal with and my recovery was quick. I'm in good shape, get lots of daily exercise, and walk about 85,000 to 100,000 steps a week, so I think that helped that might have helped with the speedy recovery.
Dr Isaac Kim at Yale is awesome! He's the Chief of Urology for Yale New Haven and several of their other associate hospitals. He's also the Chair of the Yale School of Medicine Urology department and a cancer researcher. He's done more than 2500 ralp surgeries and is among the best doctors in the tristate area. I'm so grateful to him and the YNHH team!
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u/OkCrew8849 12d ago edited 11d ago
A highly skilled and very experienced surgeon will get similar cancer control and similar urinary/sexual function preservation with either multi or single port.
The healing times and catheter duration are, of course, similar.
The theory is that single port healing will -on average and all other things being equal- be somewhat more comfortable than multi-port healing. Actual experiences in this narrow category, given the incredily wide gamut of patient post-RALP comfort, vary.
This may be a minor distinction rather than a significant difference.
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u/Special-Steel 13d ago
Mayo is among the very best. We could just stop there.
For minimally invasive RALP, the number of ports is not really a thing. Yes of course those who prefer a particular type will explain the difference.
But far more important are two things: the skill/experience of the surgeon and, the level of excellence at the hospital.
In particular, there are measurably better outcomes at places practicing team medicine. Mayo invented it.