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What do Michigan, Ohio, Florida, and Tennessee have in common? Lee Jackson, MD, for one thing.

Jackson, a board-certified urologist and prostate cancer surgeon, has extensive experience with both open prostatectomies and laparoscopic procedures. These days, though, his specialty is performing laparoscopic radical prostatectomies via the da Vinci® Robotic Surgical System. ("I've done 527 so far," he reflected.)

Honestly, it's a bit difficult to slow Jackson down once he begins to hold forth on the glories of this robotic technology and the positive impacts it can have for prostate cancer patients.

"It would be hard to overemphasize how much robotic surgery adds to treatment management by greatly reducing the recovery time for patients," he said.

This issue of recovery time for patients who have had prostatectomies is important for Jackson. As he put it, looking back on his early days as a prostate cancer surgeon, "I was disturbed because so many young men wouldn't go through with the surgical treatment because the recovery time required was too long. That many weeks of recovery, with jobs and families to support—they wouldn't do it." In his mind they were compromising their long-term health because the recovery time was too much of a burden.

Then, in December of 2001, he saw the robotic surgery procedure first-hand, and the lights came on.

"I was instantly convinced that this was the answer," he said. "It addressed directly the burden of treatment and quality of life issues."

Indeed, though Jackson characterizes his introduction to the robotic system as largely an accident, it is an accident for which he was clearly destined (even though, as he observed, the technology was originally designed for use in cardiothoracic procedures).

In 2002, he began a process of intensive training and practice to become proficient with the technology, from performing work on cadavers in California to increasing his skills at East Carolina University. By 2004, he was performing the procedure in Florida.

Though his medical training and experience had focused in large part on renal transplantation and renovascular surgery, it turned out that the demand in Florida for cancer treatment was greater than for transplants. "Two years ago, robotic prostatectomies totally eclipsed my other work," he said.

Jackson observed that, since positive results are directly related to experience in this field, he was fortunate that no one else in Florida was performing this particular procedure. Also, he said, it helped considerably that he had such extensive experience with the open surgery technique.

When discussing the initial resistance by some in the medical community, Jackson expressed appreciation for the concerns about the viability of the robotic approach when it was still relatively new.

"The concerns were legitimate," he stated. "We would be operating on people without actually touching them, without the tactile feel of the tissues involved."

Still, he is not surprised that time has vindicated his initial enthusiasm. He said, "Institutions such as Vanderbilt and UC Irvine have demonstrated that the positive margin rate is as good as with open surgery. The results have been repeated with different hands. This technique is no longer investigational."

In the meantime, he recently moved to what he has long considered his home, Tennessee. "I was born in Nashville," he explained, "but was raised in Michigan. Even then, I always saw Tennessee as my home, maybe in part because I had relatives there."

In Michigan, he said, he was strongly encouraged to go into medicine by the example of his mother, who was a nurse, while his father imparted a strong work ethic. And as for Jackson, "There was never any question of doing anything else for as long as I can remember," he said.

He earned his medical degree from the University of Michigan and ultimately completed a renal transplantation and renovascular surgery fellowship at the Cleveland Clinic Foundation in Cleveland, Ohio. He was subsequently affiliated with the Cleveland Clinic's Florida branch, where he served as the chairman of the Department of Urology for over 17 years.

Now, though, he is in Tennessee—and he couldn't be happier.

"I love it here in Chattanooga," he enthused. "The people are nice; there is incredible natural beauty. It's almost too good to be true."

And he hopes to help make it clear to prostate cancer patients in the region that the da Vinci® Robotic Surgical System is also "too good to be true" in its own way. "It's wonderful to be able to say to people, 'You don't have to go to Nashville.' Everybody wants to recover at home."

There is a balance to be struck, though. "You want to be somewhere where they do a lot of this," he explained. "It's good to see this spreading out more into the community, but the risk is that you could end up having a machine somewhere, but the surgeon doesn't have much experience. Then you could do harm."

Then there is the almost pastoral dimension that comes with much experience. He said, "We must be acutely aware of quality of life issues, especially with prostate cancer. Here we are dealing with issues such as a man's ability to control his urine and erectile function. Both clearly affect a man's sense of dignity. You gotta care about folks."

In any case, it seems that Florida's loss is Tennessee's gain, as Jackson brings his wife (of 27 years) and children to Chattanooga, along with his skill and passion for excellence in cancer treatment to Memorial Health Partners.

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