Keeping it cool

Ahlering uses hypothermia to boost quality of life for prostate surgery patients

A prostate cancer diagnosis raises enough fears without adding the sometimes daunting side effects of surgery.

Dr. Thomas Ahlering, UC Irvine urologic oncology director, has found a solution by keeping it cool. When the patient goes under anesthesia, Ahlering uses a device he helped develop that lowers the pelvic region temperature to about 80 degrees. The cooling prevents normal inflammation caused by the surgery, limits injury-related swelling, allows for quicker recovery times and reduces the duration of a common post-op side effect, urinary incontinence.

In a recent study, Ahlering found the average time for patients to regain continence was 39 days for those who received the procedure, and 59 days for those who didn’t.

“Postoperative quality-of-life issues are vitally important for men who undergo prostate surgeries,” Ahlering said. “It’s essential to explore all options to lessen the length of urinary incontinence, and we are excited that this procedure is producing such promising outcomes.”

Ahlering also has found that the minimally invasive da Vinci Surgical System augments hypothermia’s benefits. Featuring precision robotic arms equipped with a lighted camera and surgical instruments, the system performs delicate surgeries through incisions no wider than a fingertip.

About 186,000 men will be diagnosed with prostate cancer in 2008 and nearly half of those will undergo prostatectomies. In 2001, fewer than 250 robotic procedures were performed in the United States. Four years later, there were 16,000; this year, an estimated 65,000 patients opted for robotic surgery. Ahlering himself has performed more than 750 robot-assisted radical prostatectomies.

“The robotic version is becoming the surgery of choice for prostate cancer patients,” Ahlering says. “The growing preference for this technique has been dramatic.”

Minimally invasive surgery is a hallmark of the Department of Urology, which has been listed by U.S. News & World Report in its “Best Hospitals in America” issue for the past three years; it ranked 18th this year.

Prior to da Vinci’s arrival at UCI in 2002, Ahlering performed a variety of urologic cancer procedures. After his first robotic surgery, though, he knew he’d reached a turning point in his career.

“I was confident that this technique ultimately would replace open surgery,” he says. “That certainly has proven to be the case.”

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