Cutting-edge technology: meet the da Vinci robot
Posted on 30 May 2016
The da Vinci Si HD robotic system was introduced at Mediclinic Durbanville to help with complex surgeries such as prostatectomies, using a minimally invasive approach. Mediclinic currently has four urologists who are accredited to use the system – Dr Gawie Bruwer of Mediclinic Durbanville, and Drs Pierre van Vollenhoven, Dr Andre Naudé of Mediclinic Panorama and Dr Stephan Janse van Vuuren.
Why robotic surgery?
The surgeon is in control of the da Vinci system, which translates his hand movements to be performed by the tiny instruments. The precision of the system aids the thorough removal of cancerous tissue. The reduction in blood loss compared to open surgery lowers the risk of blood transfusions and patients’ pain levels are comparatively lower. ‘I firmly believe this technology is giving patients the option of improved clinical outcomes that may not be possible with open surgery,’ says Dr Bruwer.
What are the benefits for the patient?
• A shorter hospital stay – more than 60% of Dr Bruwer’s patients were discharged the day after surgery.
• The risk of infection is reduced and recovery is far quicker.
• Patients don’t need a catheter for as long as patients who have open surgery.
• Patients can return to work as soon as two weeks after surgery – far sooner than the six weeks required after traditional surgery.
‘With the psychological effect the condition had on me, it was a relief to know I was being offered the most modern prostatectomy operation available,’ says former patient Rainer Ladewig. ‘I was walking around the hospital without intense pain, besides the discomfort where the incisions were made. I can’t believe the mild experience I had with the operation.’
What’s the outcome of robotic surgery?
Dr Bruwer has been closely monitoring the outcomes of his surgery. It’s not just the patients’ quick recovery that matters to him, but also the treatment of the disease. ‘A biopsy is done on the patient that provides us with an initial Gleason score*, which together with a PSA score helps to guide therapy for prostate cancer,’ explains Dr Bruwer. ‘There is a significant upgrade in aggressiveness of the Gleason score in more than 50% of patients once the excised prostate is analysed by the pathologist. If this is not known to the treating doctor acting only on the biopsy result, it could lead to possible under-treatment. This new information allows the urologist or oncologist to adjust further treatment accordingly.’
What other surgeries can the da Vinci system do?
Nephrology and colorectal surgeries are already being performed overseas using the da Vinci system, and it’s only a matter of time before these procedures are available at Mediclinic hospitals too.
Want to see the da Vinci up close? Take a walk through below:
Your results from a prostate biopsy are usually given as a Gleason score. The glandular pattern is compared to that of a normal prostate and scored out of 5, where 1 resembles a pattern very close to normal and 5 resembles severely distorted glandular architecture. The two predominant glandular patterns within the cancer are graded out of 5 and the combined score calculated out of 10. The higher the Gleason score, the more aggressive the tumour and the worse the prognosis.