Dr. Abaza's Advanced Surgical Outcomes


Minimally invasive surgery with robotic technology creates less trauma for the patient, less risk of complications, less pain and blood loss, faster overall recovery time, a shorter hospital stay and a quicker return to normal activities.

Dr. Abaza’s advanced skill and experience gives every patient the best chance at an excellent result. As one of the highest volume robotic surgeons in the world, Dr. Abaza closely monitors his patients’ outcomes by tracking detailed data for each patient, including over 500 data points for prostate cancer patients and more than 80 data points for kidney cancer patients, to ensure quality and continually improve patient experiences.


Prostatectomy

Surgical removal of all or part of the prostate gland is called a prostatectomy.  Dr. Abaza performs this procedure using minimally invasive surgery with robotic technology. The chart below provides outcomes for these robotic surgeries performed by Dr. Abaza.

Although Dr. Abaza is fully trained in open prostatectomy, he has not had to perform this procedure in his practice and has never had to convert a robotic procedure to open surgery due to inability to complete the procedure or for complications.
Robotic Prostatectomy Outcomes for Dr. Ronney Abaza
Average operative time (including lymph node dissection) 2.5 hrs
Conversion to open surgery 0%
30-day reoperation rate <1%
Average blood loss <4 ounces
Transfusion Rate 0.5%
Hospital discharge day after surgery 99.3%
Drain-free rate 99%
Average catheter time 5.6 days
No leak on cystogram for catheter removal 99%
Average number lymph nodes removed per patient 8.1 nodes
Negative margins in organ-confined disease (T2c or less) >93%
Bladder neck contracture 0.2%
Urethral stricture 0.3%
Rectal injury <0.1%
Bowel injury <0.1%
Fecal (stool) incontinence 0%
PSA <0.1 at 3 months 99.5%*
PSA <0.1 at 1 year 97%*
PSA <0.1 at 2 years 96%*
PSA <0.1 at 1 year with positive lymph nodes 91%**
* includes patients who had positive lymph nodes (cancer that had already spread at the time of surgery)
** a PSA of <0.1 indicates undetectable cancer or “remission” of the prostate cancer, and patients with cancer in their lymph nodes rarely achieve a long-term cure; nevertheless, some patients with positive lymph nodes can be cured by surgery if a thorough enough lymph node dissection is performed


Kidney Cancer Surgery Outcomes

Dr. Abaza offers robotic surgery for the management of kidney tumors, previously thought to require open surgery. For example, Dr. Abaza was the first in the world to describe robotic surgery for kidney cancer invading the vena cava – a highly complex operation. Dr. Abaza has successfully removed kidney tumors invading the liver, the pancreas, the duodenum and other nearby organs without having to resort to traditional open surgery. Dr. Abaza was the first to show that with experience, a full lymph node dissection for kidney cancer can be performed robotically.

Dr. Abaza can offer robotic partial nephrectomy (kidney sparing surgery) for large tumors, deep tumors and tumors near major blood vessels. Dr. Abaza was the first to perform robotic partial nephrectomy for tumors invading into the renal vein. National data indicates that around the country only about one third of kidney tumors are removed with sparing of the kidney. In contrast to this, Dr. Abaza is able to perform partial nephrectomy and spare the kidney in more than 2/3 of cases.
Robotic Partial Nephrectomy (Kidney Sparing) Outcomes for Dr. Ronney Abaza
Average blood loss 5 ounces
Transfusion rate 1%
Urine leak 1%
Renal failure 0%
30-day reoperation rate 0.5%
Interventional radiology (bleeding) 0%
Overnight stay in hospital 97.6%
Average hospitalization time 1.1 days
Robotic Nephrectomy* (Entire Kidney) Outcomes for Dr. Ronney Abaza
Average blood loss <3 ounces
Average number of Lymph Nodes** 13
Transfusion rate 0.9%
30-day reoperation rate <2%
Average hospitalization time 1.1 days
Overnight stay in hospital 95%*
* includes complex tumors invading other organs
** in patients with an indication for node dissection


Robotic Adrenalectomy and Partial Adrenalectomy Outcomes

Dr. Abaza reported the first application of robotic surgery to primary adrenal cancer. He performed a live adrenalectomy procedure transmitted to Las Vegas for the 6th Annual International Robotic Urology Symposium. Dr. Abaza performs the surgery in as little as 30 minutes, and patients can expect to be able to go home the same day, if they prefer. Most importantly, Dr. Abaza offers partial adrenalectomy for selected patients with amenable tumors that allows sparing of the normal portion of the adrenal gland.
Robotic Adrenalectomy and Partial Adrenalectomy Outcomes for Dr. Ronney Abaza
Operative time 1 hour
Average blood loss <1 ounce
Transfusion rate 0%
30-day reoperation rate 0%
Average hospitalization time .75 days
More than overnight stay in hospital 0%


Pyeloplasty Outcomes

Surgery to remove a urinary obstruction  is called pyeloplasty. Dr. Abaza’s consistent success with robotic pyeloplasty includes a water-tight repair allowing avoidance of abdominal drains and removal of the bladder catheter before discharge, with almost all patients able to go home the day of or the morning after surgery.
Pyeloplasty Outcomes (UPJ Obstruction) for Dr. Ronney Abaza
Operative time (including stent) 2 hour
Successful repair 98.3%
Average blood loss <1 ounce
Transfusion rate 0%
No drain 99%
30-day reoperation rate 0%
Average hospitalization time 0.9 days
More than overnight stay in hospital 2%
Catheter removed prior to discharge 100%


Cystectomy Outcomes for Bladder Cancer

Dr. Abaza performs robotic bladder cancer surgery with the same attention to detail as with more common robotic procedures and a drive to provide better outcomes than anywhere else.  As a more aggressive type of cancer, bladder cancer requires a thorough surgery, which includes a high-quality lymph node dissection, as this can sometimes mean the difference between cure and eventual death from the disease.  Dr. Abaza was the first to report robotic extended lymph node dissections for bladder cancer that match the quality of the best open surgeons in the World.  Dr. Abaza’s report of >40 nodes obtained on average per patient exceeded all other reports to date with laparoscopic or robotic surgery, which had previously never exceeded 25 nodes.
 
In addition, Dr. Abaza’s consistency of outcomes with bladder cancer surgery allows his patients to have the lowest reported hospitalization time, with most patients going home on postoperative day 3.  This reflects 1-3 less days in the hospital on average compared with most other institutions offering robotic cystectomy.


Dr. Abaza’s outcomes above were published in medical literature.