cancer surgery with a PM

Hi friends!
I've had a PM for 3 years and now I need to have surgery for prostate cancer and the Dr wants to use the Da Vinci Robot technique. I feel anxious and was wondering if there's anybody out there who's had to have surgery not related to the PM and what precautions the Dr should make.Thanks!

3 Comments

Shouldn't be a problem

by cohara - 2014-09-10 08:09:28

I have had laparoscopic abdominal surgery and thyroid surgery. The thyroid was within 6 inches of my pacemaker. No issues with either surgery. There are two types of electrocautery. Bipolar confines the current between the two poles of the device, so it doesn't pass through your body. That was used for the thyroid surgery. Monopolar uses a grounding plate. It is usually quite safe for use below the waist as long as the grounding plate is also below the waist.

I was more concerned with the thyroid surgery. In particular, I don't want my settings lost, so I make it a practice to take a copy of my settings with me into surgery and make sure my rep is available to check it out afterwards and to assist if something arises. I am pacemaker dependent, so I'm extra cautious. I also had a nice chat with the anesthesiologist before the procedure and discussed the limitations of relying solely on magnets. Donr has a good article written in plain English about pacemaker management during surgery. It gives you some good talking points for the pre-surgery chat.

I wish you luck,
Carol

surgery

by Tracey_E - 2014-09-10 08:09:47

I have no idea what that technique is but generally surgery is fine, just make sure the anesthesiologist knows early enough to get someone to be there to monitor the pm. They change the mode for surgery, then put it back when they're done. We can't have electro-cautery. That's all I can think of, I'm sure someone will jump in if I missed anything! Good luck to you.

Do research! and Plan ahead

by flutetooter - 2014-09-10 11:09:33

I just got my PM in Feb. 2014 and had a 6 item lower abdominal procedure scheduled (and successfully completed) on July 8, 2014. That involved an open hernia repair and a vaginal hysterectomy with 4 related prolapses, etc. to be repaired. ALL procedures (with 2 different surgeons and operating room teams back to back) involved electrocautery. For my hernia the total blood loss was only 1/3 teaspoon!

Especially with Da Vinci Robot or laparoscopy (which takes even longer under the anesthetic than open repairs because it is more technical) cauterizing the cuts as they are made with with bipolar scissor type instruments (safer) or a Bowie type single narrow blade slicing tool which also cauterizes as it cuts, controls the blood loss. The bipolar scissors contain the electric current which goes from blade to blade. I don't know where the current goes with the Bowie. Both require a grounding patch, preferably on your thigh to draw all the excess current away from your pacemaker. Look up restrictions for your particular brand of pacemaker and your particular condition and send a private message to "donr" for the link to what surgeons need to know about pacemakers before surgery.

Da Vinci and laparoscopy surgery require instruments to be inserted through your abdomen from sites not immediately above the surgical goal area and bleeding must be controlled with something other than stitching up every cut
Nowadays almost every surgical procedure uses electrocautery to keep a patient from excess bleeding.

For the Da Vinci, your doctor needs to be very qualified. Yes, a PM technician would be great to have on hand, but in smaller hospitals they just slap a magnet on and operate. That can be O.K. and not O.K. depending on the doctor's skill and knowledge of your PARTICULAR reasons for having a pacemaker. Just take the time to cover all bases with your surgical team and all will be O.K. I was in the hospital only overnight and walking and getting out of bed from the first morning with minimal pain. I had also placed many phone calls and checked out web information and 'You Tube" videos. p(

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