Robotic surgery has had the greatest impact on the treatment of localized prostate cancer as Robotic Radical Prostatectomy is the most commonly performed robotic surgical procedure. Although, Robotic Radical Prostatectomy is a relatively new procedure it has grown rapidly in popularity, and is now the most common surgical approach to treat localized prostate cancer. As with open radical prostatectomy, Robotic Radical Prostatectomy involves removal of the entire prostate and seminal vesicles with re-connection of the urethra and bladder. The goal of Robotic Radical Prostatectomy is to remove all of the cancer without disrupting normal urinary, bowel and sexual function. Since the DaVinci Robot provides a magnified field of vision along with enhanced surgical dexterity, Robotic Radical Prostatectomy can usually be performed with less blood loss and fewer side effects than the typical open radical prostectomy. Studies have also suggested that cancer control rates may be improved with robotic surgery.

Robotic Radical Cystectomy is a relatively new procedure that is now commonly performed by a limited number of robotic surgeons. Dr. Ornstein is a pioneer in this field {Robot-Assisted Laparoscopic Radical Cystoprostatectomy and Totally Intracorporeal Ileal Neobladder}, and has one of the largest experiences with Robotic Cystectomy and urinary diversion on the West Coast. As with Robotic Radical Prostatectomy, Robotic Radical Cystectomy is associated with less blood loss, lower risk of transfusions, fewer complications and faster recovery than standard open or laparoscopic cystectomy{Comparative Analysis of Laparoscopic and Robotic-Assisted Radical Cystectomy with Ileal Conduit}. Robotic Radical Cystectomy involves removing the bladder along with the prostate and seminal vesicles in men. In women the uterus, ovaries and fallopian tubes are typically removed, but can be preserved in selected cases. An extended pelvic lymphadenectomy is routinely performed during radical cystectomy. Once the bladder and lymph nodes have been removed robotically the options for urinary diversion include {Urinary Diversion }; orthotopic neobladder (a new bladder created from the patient's own intestines and connected back to the urethra), a continent cutaneous diversion (a new bladder created from the patient's own intestines that is connected to the skin and requires intermittent catherization to drain) and an ileal conduit (that drains urine continuesly into a plastic bag that is stuck to the abdominal wall).

Recently, Dr. Ornstein has utilized the DaVinci Robot for partial nephrectomy and along with his associates have demonstrated that the robotic approach to less invasive partial nephrectomy is easier to learn than standard laparoscopy {Robotic versus Standard Laparoscopic Partial / Wedge Nephrectomy}. In our experience robotic partial nephrectomy is the safest and most effective minimally invasive technique for partial nephrectomy. Robotic Partial Nephrectomy is performed through 5 – 6 small holes (each smaller than 1 cm) in the abdmonal region, and is associated with less pain and fewer side effects than traditional open partial nephrectomy which is usually performed through a large incision in the side. Robotic partial nephrectomy is also associated with less blood loss and a lower risk for a blood transfusion than open partial nephrectomy. It has now been shown by our group as well as by others that robotic partial nephrectomy can achieve similar cure rates to that of open partial nephrectomy.