Treating prostate cancer
In South Africa, as in Europe and the United States, robotic-assisted surgery is becoming the procedure of choice for prostatectomy, the surgical removal of the prostate gland.
The da Vinci Si robotic technology was introduced at Netcare Waterfall City Hospital in Midrand and Netcare Christiaan Barnard Memorial Hospital in Cape Town in mid 2014. Since then no fewer than 200 prostatectomies have been successfully performed using the system.
According to urologist Dr Marius Conradie, who is part of the robotic surgical programme at Netcare Waterfall City Hospital, by far the majority – approximately 80 percent – of prostatectomies being undertaken in countries such as the United States are now being performed using robotic technology.
“It is not surprising that the technology is being adopted so readily, because it offers many advantages over traditional forms of open surgery. For example, it requires smaller incisions than open surgery, and surgeons achieve greatly improved outcomes with less risk of infection and other complications. There is reduced blood loss and therefore less need for blood transfusion. In addition, patients experience less post-operative pain,” notes Dr Conradie.
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 with open or laparoscopic surgery. This means the cancerous tissue can be more accurately removed and doctors are better able to preserve the nerves that control both erectile function and continence. This ensures that the risk of incontinence and erectile dysfunction is reduced considerably.
Reducing recovery time
Another benefit of the da Vinci procedure is that it results in a reduced hospital stay and shorter recovery period than traditional open surgery. According to Netcare statistics, the average patient stay in hospital is being reduced by more than half through the use of the technology when compared with open surgery.
Dr Gregory Boustead, consultant urological and robotic surgeon and consultant advisor in robotic surgery to Netcare hospitals, says that medical schemes are also increasingly acknowledging the benefits of the robotic-assisted prostatectomy and are increasingly opting to fund it. Of the patients that have undergone the operation at Netcare Waterfall City and Netcare Christiaan Barnard Memorial hospitals, just a few have had to fund it entirely on their own.
Dr Boustead says that while the da Vinci technology is initially being used for radical prostatectomies, the versatile technology will, in time, also be extended to other urology applications and within other medical disciplines, as is the case internationally.
“In fact, Dr Conradie has already performed a successful nephrectomy, the removal of a cancerous kidney in a patient, in April this year at Netcare Waterfall City Hospital. It was the first ever robotic-assisted procedure of its kind in South Africa,” he observes.
“The introduction of the da Vinci technology provides urologists with a highly sophisticated new weapon in the fight against prostate cancer. Bringing it to Johannesburg and Cape Town was not only an investment in South African medicine, but an investment in the advancement of medical practice, and the health of the men of this country,” concludes Jacques du Plessis, managing director of the Netcare hospital division.
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