The newest approach to prostate cancer

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St. Joseph’s Healthcare Hamilton will soon be one of only a hand-full of hospitals in Canada that are able to offer patients the newest approach to prostate cancer.

Laparoscopic Radical Prostatectomy is a minimally invasive prostate cancer surgery that profoundly reduces bleeding, pain, and recovery time.

Dr. Eddie Matsumoto says that less than a dozen surgeons in Canada perform the procedure. “It’s very challenging. Prostatectomy in itself is challenging because you want to maintain erectile function and continence mechanisms. But for this procedure you need an advanced set of laparoscopic skills.”

Dr. Matsumoto first honed his skills in the Urology Program at the University of Toronto. While in residency he was accepted into the Surgical Scientist Program. He then completed a Master’s in Health Professional Education focussing on evaluating and training of surgical residents, before heading to the University of Texas and the renowned Southwestern Medical Centre in Dallas. There he earned a fellowship in laparoscopy and endo-urology.

“With this procedure, patients gain the greatest benefit,” says Matsumoto. “The recovery time is a lot shorter than open surgery, most often they’ll be out of the hospital in two days. Blood loss is less; patients may not require a transfusion at all. They don’t require as much pain medication and they return to full activities a lot quicker.”

The procedure is done through several small incisions in the abdomen, rather than a large, open one. Specially designed surgical instruments and cameras afford the surgeon precise control and excellent visibility for performing the operation.

Some surgeons claim that the Laparoscopic Prostatectomy provides better preservation of urinary continence and erectile function. “The outcomes reported by some centres suggest as much as an 80 per cent erectile function preservation. And that may be because of the visualization. You can see the nerves a lot better; the field is less bloody, so that you can dissect more accurately. With this procedure, the movements are more refined and less trauma and inflammation are caused. Similarly with the continence mechanisms. I believe the outcomes are certainly as good, if not slightly better.”

The procedure is not meant for everyone. There are other options.

Dr. Matsumoto – a Hamilton native – has returned to his hometown to take up a role at the new McMaster Institute of Urology at St. Joseph’s Healthcare. The opportunities here were so exciting he chose to turn down offers at John Hopkins University and Washington University.

“It’s very exciting to be able to offer this procedure to this area – exciting and challenging.”

Dr. Matsumoto won’t have a lot of time on his hands. As well as his role at the urology institute, the new residency program in urology here at St. Joseph’s thrills him. “It’s one of the first in Canada in twenty years and that’s great. It’s exciting to be one of the founding fathers of this program and as a surgical educator I have a lot of interest in teaching.”

He’ll pursue that interest working with colleagues at McMaster University to develop a technical skills lab. The lab would be broad based and offer opportunities for anesthesia residents, for those in ob/gyn and family medicine and others, as well as for the undergraduate program.

“The end result will be developing new methods of evaluating, assessing technical competence and developing new ways of teaching residents outside of the operating room,” says Dr. Matsumoto. “Because that’s really the bottom line. We really don’t have the resources or the operating room time to be in there teaching residents. It’s still an important venue for teaching, but we don’t have the luxury of letting a resident take a case from beginning to end. We want to be able to flatten out the learning curve so that when they get into the OR they’re ready to maximize the opportunity. “