(The New York Times News Service) -- Sitting in front of a screen several feet from the operating table Wednesday, Dr. David Lee grasped the hand controls of what looked like a video game as he began removing his patient's prostate.

A robot with three hands -- including one to hold a camera inside the 55-year-old patient -- did the rest, following the surgeon's every hand control as Lee performed the first robotic radical prostatectomy in North Texas.

Using the camera as his eyes, Lee could see a bright, three-dimensional, magnetized image of a prostate, something that is not possible with conventional surgery.

"With this, your vision is so good, and the robot's hands work so well," said Lee, director of robotic and laparoscopic surgery for Urology Associates of North Texas. "You feel like a little person inside the patient."

Nationwide, robotic surgery is being used more and more to remove gallbladders and repair hearts. In 2001, the Food and Drug Administration approved the da Vinci Surgical System for the removal of prostates.

Robotic surgery has been used in Dallas to treat other conditions, but Wednesday's operation at Arlington Memorial South Medical Center was the first time that it was used to remove the prostate.

For men with cancer confined to the prostate, robotic surgery can cure the disease, Lee said. About 10,000 cases of invasive prostate cancer are diagnosed in Texas each year, according to the American Cancer Society.

With robotic surgery, the risk of impaired sexual function and incontinence is also reduced, Lee said. With conventional surgery, about 80 percent of men no longer need a pad for incontinence after six months, and from 90 percent to 95 percent of men no longer need a pad after a year, he said. With the robotic surgery, men are usually pad-free after three months.

Although the amount of data on potency with robotic surgery is insufficient, the robotic hands allow doctors to be more precise, thus sparing nerves that can effect urinary control and impotence, Lee said.

With less pain and less blood loss, robotic surgery also has a shorter recovery period than conventional surgery. Doctors make six tiny incisions in the abdomen, then insert the laparoscopic arms and camera through the openings. With a conventional radical prostatectomy, doctors make an incision across the abdomen.

Patients spend 24 hours in the hospital, compared with two to four days of hospitalization after traditional surgery. After a week, patients feel as if they have never had surgery, said Lee, who performed about 60 robotic-assisted radical prostatectomies during his training at the University of California, Irvine.

Less than five hours after surgery Wednesday, Dick Cavett of Austin was sitting up in bed, drinking hot tea.

"I had the option of having my gut split open, but I've had back surgery and didn't want to do that again," he said. "This is just like a miracle to me."

Robotic prostate removal makes a technically challenging and complex surgery easier, said Dr. Jeffrey Cadeddu, an assistant urology professor at the University of Texas Southwestern Medical Center at Dallas.

"Instead of having to do it all with your hands using conventional laparoscopic instruments, the surgeon is able to sit down and drive a very comfortable console," he said.

The procedure is similar to laparoscopic surgery -- in which long instruments are inserted into the body through a tiny incision -- but instead of the surgeon holding the instruments with his hands, the robot performs that task, he said.

The downside: The equipment costs about $1 million, Cadeddu said.

During the surgery, which takes about five hours, robotic grippers and scissors are used to cut, suture and move tissues.

Tiny robotic wrists that can rotate 360 degrees give doctors the freedom to move the arms up and down or side to side inside the body, said Lee Monlezun, an account manager for Intuitive Surgical, the California-based maker of the da Vinci Surgical System.

"They can move any way the human wrist can," he said. "In fact, they move in more ways than the human wrist."

While the surgeon sits in a corner of the operating room manipulating the controls that make the arms move, another surgeon works at the operating table making sure that the laparoscopic tools are properly inserted. A small bag is used to remove the prostate, which is typically the size of a walnut but becomes enlarged when cancerous, Lee said.

For Cavett, who waited nearly a year before deciding to have treatment for prostate cancer, the operation went so well that he had nothing but praise for the surgeon and the robotic equipment.

"I feel like this was one of the luckiest days of my life," he said. "I feel like a bionic man."

Copyright 2003 The New York Times News Service. All rights reserved.