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Dr. Samadi's prolonged success is partly due to the fact that he performs each procedure himself, using the same dedicated operating room team and no trainees. "The best place to teach residents and fellows is in simulation labs," he says. "Just as pilots don't get in a plane carr ying 500 passengers, surgeons shouldn't be thrown into the operat- ing room and told to go practice on people. Patients should be protected from such situations. They have only one sex life, and ner ve damage and continence issues heavily impact their quality of life. To get the best outcomes, the most skilled surgeon should lead in the operating room." On the Front Lines Dr. Samadi's oncology training gives him a unique perspective, a mental tumor board continuously deliberating over treatment options. He recognizes the value of multimodal therapies for later-stage cancers and notes that sur- gery is the best option for early-stage, localized prostate cancer. When open surger y held greater prominence in prostatectomy methodol- ogy, radiation was a popular frontline alternative for indicated cases. However, radiotherapy has been consistently shown to produce more complications than does s u r g e r y, m o s t c o m p r e h e n s i v e l y SMART technique, defining the surgical pathway for better outcomes EXPERIENCE OVERCOMES CHALLENGES PROSTATECTOMY CAN BE a challenging procedure, even for surgeons who have access to the most advanced technology and perform the operation with regularity. Robotic surgical systems represent the most state-of-the-art tools for prostatec- tomy, and while features of the robotic systems enable greater surgical precision, success depends on the skills of the surgeon operating them, according to David B. Samadi, MD, Chair of Urology and Chief of Robotic Surgery at Lenox Hill Hospital and Professor of Urology at Hofstra North Shore-LIJ School of Medicine. In 2010, a patient decided to undergo prostatectomy at a hospital in Maryland. The surgeon had successfully performed hundreds of similar operations, and the patient felt comfortable with the decision to proceed with curative surgical resec- tion instead of radiation. More than two hours after the surgery began, the patient woke up and was told that the procedure was aborted because of weight-related respiratory complica- tions. The surgeon recommended weight loss and open surgery or radiation as future treatment. In the days following the unsuccessful procedure, the patient was directed to a prostate cancer survivor who had successfully undergone robot prostatectomy performed by Dr. Samadi. Hesitant to call Dr. Samadi out of the blue, the patient was surprised when Dr. Samadi called him. The patient flew to New York for consultation, in which Dr. Samadi quickly identi- fied misplaced port incisions — not the patient's weight — as the reason the initial surgery failed and recommended a rare reoperation to remove the prostate. In less than one hour, Dr. Samadi successfully removed the patient's prostate, curing his cancer while maintaining urinary control and facilitating rapid return of sexual function. Extraordinary success stories like this are all in a day's work for Dr. Samadi, who is dedicated to compassionate and successful prostate cancer treatment, preserving the highest possible quality of life for men of all ages. "Technology plus experience equals good outcomes," he says. "Technology without experience equals complications. It's not the robot that performs successful surgery; it's the surgeon operating the controls." M D N E W S . CO M ■ MD NEWS Long Island | 9