Robotic-assisted surgery for prostate cancer

Gerine Hoff
Highly sophisticated robotic-assisted surgery for the treatment of localised prostate cancer is rapidly catching on in South Africa and, as in Europe and the United States, it is becoming the procedure of choice for prostatectomy, the surgical removal of the prostate gland.
Jacques du Plessis, managing director of the Netcare hospital division, says Netcare introduced da Vinci Si robotic technology at Netcare Christiaan Barnard Memorial Hospital in Cape Town and at Netcare Waterfall City Hospital in Midrand in mid 2014. Since then the technology has been used to successfully perform well over 200 prostatectomies at the two hospitals.
The Da Vinci system is designed to assist surgeons in performing highly intricate procedures, such as prostatectomy, with much greater accuracy.
“We expected that, at the most, 150 surgeries would have been done using Da Vinci technology by this time. The higher number of procedures completed indicates that men with prostate cancer are becoming more aware of the benefits of this cutting edge technology. I have little doubt that the demand for robotic-assisted surgery will also continue to increase in this country,” adds Du Plessis.
Du Plessis says that most - approximately 80% - of prostatectomies being undertaken in countries like the US, are now being performed using robotic technology.
According to Dr Steve Eppel, a urologist who practises at Netcare Christiaan Barnard Memorial Hospital, studies have shown that in the hands of a well-trained surgeon, Da Vinci robotic surgery delivers consistently good outcomes for patients compared to the more traditional forms of surgery for prostate cancer, and also results in fewer complications.
“The Da Vinci Si system allows a three-dimensional, high definition view of the area being operated on and enables far greater surgical precision than is possible with open surgery. It effectively allows the practiced surgeon to operate within finer margins, which means there is less chance of leaving any cancerous tissue behind, providing good cancer control,” says Eppel.
In addition, the technology gives surgeons the ability to perform more accurate nerve-sparing prostatectomies, ensuring that the nerves controlling erectile function and urinary continence are better preserved. The result is that patients experience a faster return to normal erectile function. Studies have also shown that patients have improved early outcomes from a urinary continence point of view, added Eppel.
Dr Anesh Naidoo, a urologist based in Cape Town and who forms part of the Da Vinci programme at Netcare Christiaan Barnard Memorial Hospital, says that among the numerous benefits of the Da Vinci procedure, is that it results in a reduced hospital stay, a shorter recovery period and a quicker return to daily activities.
According to Netcare statistics, robotic-assisted prostatectomy has reduced the average patient stay in hospital by more than half when compared with open surgery: from 7.85 hospital days to just 3.37 days. In other words, men are able to get back on their feet considerably sooner.
“Keep in mind that prostate cancer is not just a disease of the elderly, as is often mistakenly thought. The average age of the 200 patients treated at the two Netcare facilities since the introduction of the Da Vinci technology, was 61. Most of these patients were business executives who are still economically active. They wanted to get back to their normal lives as soon as possible,” says Du Plessis.
Dr Gregory Boustead, consultant urological and robotic surgeon and consultant advisor in robotic surgery to Netcare hospitals, says the introduction of Da Vinci robotic surgical technology was accompanied by an extensive training programme for urologists who were going to use the system. This has contributed to the development of critical medical skills. He explains that the technology is highly sophisticated and urologists have to be comprehensively trained and entirely competent in its use.
Dr Boustead says that while the Da Vinci technology is being used for radical prostatectomies, the versatile technology will in time also be extended to other urology applications and procedures in other medical disciplines.
“In fact, a successful nephrectomy (the removal of a cancerous kidney) was undertaken in April this year at Netcare Waterfall City Hospital. It was the first ever robotic-assisted procedure of its kind in South Africa,” he says.
“The introduction of the Da Vinci technology provides urologists with a highly sophisticated new weapon in the fight against prostate cancer,” concludes Du Plessis.
For more information on this treatment, contact Netcare Christiaan Barnard Memorial Hospital, Cape Town, at +27 21 480 6111, or Netcare Waterfall City Hospital, Midrand, Johannesburg, at +27 11 304 6600.

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Republikein 2024-11-23

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