The SMART Surgery Technique is the brainchild of Dr. David B. Samadi, a robotic prostatectomy expert, as well as the Vice Chairman, Department of Urology, and Chief of Robotics and Minimally Invasive Surgery at The Mount Sinai Medical Center in New York City. SMART, which stands for “Samadi Modified Advanced Robotic Technique,” “takes oncologic principles, combines it with open radical prostatectomy skills and builds upon it with a unique robotic surgery approach,” explains Samadi, about his prostate cancer treatment procedure he uses at Mount Sinai.
“SMART is a revolutionary and advanced prostate cancer surgery and prostate cancer treatment method which drastically reduces blood loss, pain, hospital stay, recovery time and the dreaded side effects of other treatments,” said Dr. Samadi. The procedure, which is also known as bloodless prostate surgery, duplicates the traditional open technique on the robotic platform. The technique does not require opening the endopelvic fascia or cutting the dorsal vein complex, which requires no suture and results in less damage to the neurovascular bundle.
With the SMART Technique, Dr. Samadi is able to achieve continence rates of 97% and potency rates of 81% within 1 year, all while maintaining a 4% rate of positive surgical margins. “My SMART technique should not be performed early in a robotic surgeon’s learning curve as it is an advanced technique that I have perfected over the course of over 3,000 robotic-assisted prostate surgeries – more than half using this technique,” he explained.
Intuitive Surgical’s da Vinci robot helps Dr. Samadi detach the prostate while sparing the nerves that are responsible for sexual function and continence. With its high definition 3D view, Samadi maneuvers the robot’s miniature EndoWrist® instruments to perform the delicate robotic prostate surgery. “This is why when it comes to robotics, volume adds to a surgeon’s experience, as these skills take time to master,” he explained.
Dr. Samadi, who is also a urologic oncologist and laparoscopic expert, discovered his open surgery and laparoscopic surgery skills helped add to his skills as a robotic surgeon. Samadi believes that all surgeons should obtain the same skills in order achieve the necessary experience to perfect their robotic prostatectomy skills. He explains that the robot is merely a tool that improves surgical vision and magnification by allowing angles of dissection that were previously not achieved with open or straight laparoscopic instruments. “With SMART, I can achieve a 95% cure rate in addition to high continence and potency rates, something which I like to call a ‘treatment trifecta’,” he explains.
“The most important thing for my patients is a cure, but so is their urinary and sexual function,” said Dr. Samadi, “The SMART Surgery Technique enables me to successfully give my patients all three of these vital factors and returnthem to their quality of life.”Press Releases