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Robotic technology to reduce erectile dysfunction caused by prostate surgery

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When Owen Apollis was diagnosed with prostate cancer at Groote Schuur Hospital in Cape Town a year ago, his worst fear was having surgery to remove the cancer.

“I had heard having surgery is quite painful and one has to be in hospital for many days.”

However, to his surprise on the second day after surgery he was walking on his own and on the third day the 61-year-old from Mitchells Plain was at home performing household chores and assisting his wife with the dishes, thanks to the new robotic technology doctors used to dissect the tumour.

Apollis was one of the first five public sector patients in the country and Africa to have prostatectomies using da Vinci robotic technology. The R38m machine, which has been used in the private sector for several years, removes cancer cells more precisely without opening a wound in the affected area. Not only does it spare nerves from surgery-associated damage, but its nature as a keyhole surgery provides for quicker healing.

With the da Vinci robotic system, a surgeon operates through a few small incisions made close to the affected area, and performs the operation sitting a few metres from the patient. Looking through a console — a magnifying 3D high-definition vision system — the surgeon performs the operation using tiny instruments that bend and rotate more efficiently than the human wrist.

The magnified images allow the surgeon to see even the tiniest blood vessels. Everything is magnified 10 times with this system compared to looking with a naked eye.

Using controls connected to the laparoscopic instruments, a surgeon can cut, stitch or cauterise the wound with precision.

Not only does this result in fewer complications such as erectile dysfunction,  doctors are expecting it to cut patients’ hospital stays considerably due to quicker healing. Shorter hospital stays will translate into more operations and ultimately the reduction of waiting lists for cancer surgeries.

Dr Mark Wellman, urology registrar at Groote Schuur Hospital who assisted the hospital’s specialist urologist Dr Samkele Salukazana with the five surgeries, said robotic surgeries will save a lot of theatre time.

While the first few operations took up to five hours as the doctors are trying to perfect the new technique, in the future the surgery is expected to take just two hours, something which doctors believe will lead to more operations being done and drastically reduce cancer surgery waiting lists.

Wellman said the technology will also give registrars a chance to learn on the job.

“With traditional open surgery you can’t see that much and you don’t often get the teaching you would with the robot, which gives you a big screen that shows exactly what the surgeon is doing and you see the operation from start to finish. The benefit for doctors is that you are able to see better so for teaching purposes it’s more convenient,” he said.

Tygerberg Hospital recently became the first state facility to use the cutting-edge robotic technology to treat colorectal cancer.

Wellman said while open procedures will continue to be performed, particularly for more advanced and large prostates, robotic-assisted surgery “will be the preferred way for most patients”.

Source: TimesLIVE

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