First ever robotic-assisted prostate surgery performed in KwaZulu-Natal
Life-saving robotic technology now available in Umhlanga
Medical history was made in KwaZulu-Natal yesterday with the first ever use of a state-of-the-art robotic surgical system at Netcare Umhlanga Hospital near Durban. During the historical procedure, 50-year-old Bheki Mdlalose of Durban successfully underwent a robotic-assisted prostatectomy to remove his cancerous prostate.
“Such has been the success of Netcare’s introduction of the da Vinci Si robotic surgical system in Johannesburg and Cape Town that Netcare regarded it as critically important to also introduce the sophisticated robotic technology in KwaZulu-Natal to meet the demand for this type of procedure from doctors and patients in the province,” says Jacques du Plessis, managing director of Netcare’s hospital division.
Du Plessis says the procedure was performed by renowned urologist, Dr Marius Conradie, who has performed numerous robotic-assisted surgical procedures, and travelled from Johannesburg to collaborate with his peers to undertake the procedure at Netcare Umhlanga Hospital. Mr Mdlalose, who hails from KwaMashu near Durban, is recovering well and reportedly in good spirits after the prostatectomy.
According to the general manager of Netcare Umhlanga Hospital, Marc van Heerden, more patients have already been scheduled to undergo the same procedure with the assistance of the new system. The da Vinci robotic technology is designed to assist surgeons in performing intricate procedures, such as a prostatectomy, with a much greater degree of accuracy and fewer side effects than can be achieved with traditional open or laparoscopic surgery.
“Netcare introduced da Vinci Si robotic technology at Netcare Waterfall City Hospital in Midrand and Netcare Christiaan Barnard Memorial Hospital in Cape Town in mid-2014. Over 360 prostatectomies using the robotic- technology have already been performed at these two hospitals,” notes Du Plessis.
“Urologists trained in robotic-assisted surgery have also used this cutting-edge technology to perform a number of other groundbreaking procedures for SA, including cancerous bladder removal and the complete or partial removal of cancerous kidneys”.
Van Heerden says that number of the patients who have undergone robotic-assisted surgery at the Netcare hospitals in Midrand and Cape Town were referred from KwaZulu-Natal.
“With the introduction of the da Vinci system at Netcare Umhlanga Hospital, as well as a comprehensive training programme that the urologists who will be using the technology undergo, patients will no longer have to journey to Johannesburg or Cape Town for such treatment. I believe that this is an important development for medicine in the province,” he observes.
Dr Gregory Boustead, consultant urological and robotic surgeon and consultant advisor in robotic surgery to Netcare hospitals, says that the technology has become the gold standard for the surgical treatment of localised prostate cancer in Europe and the United States, and is also rapidly becoming the treatment of choice in South Africa.
“This is not surprising, as the technology assists well-trained surgical teams to achieve much greater surgical precision than is usually possible with open or laparoscopic surgery. There are a number of reasons for this, including the fact that it enables doctors to have a three-dimensional, high definition view of the area being operated on. The robotic arms and wristed instruments allow more freedom of movement than the human hand and the surgeon has complete control of the latter”, notes Dr Boustead.
“This means that we are able to perform surgeries within much finer margins, which not only improves the chance of removing all cancerous tissue, but also enables us to better preserve the nerves and tissue around diseased organs. In the case of prostatectomies, this means we can improve the preservation of the nerves which control urinary continence as well as erectile function. The latter is of course important to all men, particularly younger men under the age of 65, who have developed prostate cancer.”
Dr Boustead, who is one of the world’s leading authorities on the use of the technology, says that the da Vinci surgical system has many possible uses, particularly in the field of urology and gynaecology, but the new system at Netcare Umhlanga Hospital will initially mostly be used to perform prostatectomies. He further points out that the technology, while highly sophisticated, does not perform surgery on its own but is a tool that assists surgical teams to achieve improved outcomes when performing intricate procedures such as prostatectomies.
“Surgical teams need to be highly trained, which has been one of the strengths of the Netcare da Vinci programme in South Africa, as Netcare have introduced thorough training initiatives for urologists and support staff,” he adds.
“The in-depth training programme for urologists covers both product and clinical aspects through a series of online modules, simulator training, as well as hands-on surgery performed in an accredited training laboratory in Belgium. As the programme’s proctor, I then oversee their procedures until they are fully versed in its use. There is little doubt that this training programme will contribute to the development of important medical skills within KwaZulu-Natal.”
Two local Durban urologists are currently undergoing training on the system and more doctors will be admitted to the programme soon.
“Among the other benefits of robotic-assisted surgery, is that it is undertaken through minor puncture wounds rather than through the larger incisions that are necessary in traditional open surgery,” adds Dr Boustead.
“This assists in reducing the risk of complications and the length of hospital stay, with patients recovering from surgery much more quickly. Indeed, according to statistics from the Netcare robotic programme, patients’ hospital stay is, on average, more than halved. Quite understandably such benefits make robotic-assisted surgery a popular option for patients in SA. We are also finding that more-and-more medical schemes are recognising the benefits of the treatment and are covering its costs.”
“Netcare is to be applauded for introducing the da Vinci robotic system and its associated training programme in KwaZulu-Natal, which is the most populated province in the country, and where, as it is already becoming evident, there is a great need for the technology,” concludes Dr Boustead.