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I felt like I could ride a motorbike

New robotic surgical system delivers better results with fewer complications

Tuesday, August 19 2014

“I don’t feel as if I have had major surgery. Just a week after I had my prostate removed to treat the cancer I had developed, I was up and about and even felt like I could ride a motorbike or drive a car. I am pretty sure I would not have felt so strong had I not opted for da Vinci robotic assisted surgery.”

So says 46-year-old Armando Loureiro of Kempton Park, who was the first patient to have undergone this cutting edge surgery at Netcare Waterfall City Hospital. The state-of-the-art da Vinci technology has also been introduced at Netcare Christiaan Barnard Memorial Hospital in Cape Town, where a number of patients have also undergone prostatectomies – an operation in which the prostate is completely removed in patients where cancer is localised to the prostate – with the use of this technology.

“I believe that continence is sometimes a problem after open prostate surgery which, together with laparoscopic surgery, has mainly been used for prostatectomies in South Africa. I am happy to say that since the catheter was removed a week after the procedure, I have had no trouble with continence whatsoever. I also experienced minimal pain after the surgery. The operation went very well and I am pleased to have made the decision to go the route of the da Vinci robotic assisted surgery,” added Loureiro, the owner of a highly successful gym in Kempton Park.

Loureiro’s urologist, Dr Marius Conradie, who practises at Netcare Waterfall City Hospital and headed the surgical team, says he is delighted with the outcome of the procedure and the patient’s progress. “Much smaller incisions are required for the robotic assisted surgery than for traditional open surgery. Mr Loureiro was therefore able to recover much more quickly and was discharged just two days after the procedure. In our follow up appointments his test were all clear and he was continent. The outcome of the surgery has been most impressive,” adds Dr Conradie.

Loureiro has become a strong advocate for South African men going for regular prostate cancer screening as he has realised that early detection of this disease, which is the second most common cancer in South African men, is crucial in saving lives. “I have met older members of my gym who have been through prostate cancer. However, I was shocked when I myself was diagnosed with the disease, particularly as we tend to think of it as being largely a medical condition impacting older men. Younger men should not to be complacent and also be sure to be screened regularly,” he recommends.

Loureiro’s cancer was detected by chance when he went to a doctor with health questions that some of his gym members had asked him. During the consultation the doctor recommended a routine rectal examination for prostate cancer, and it was with this examination that irregularities were detected. The doctor then recommended a biopsy, which confirmed the diagnosis. “My cancer was detected completely by accident,” he observes.

Loureiro cautions South African men to ensure that they are examined by an expert as part of a complete prostate cancer screening process. “I had a prostate screening antigen (PSA) test a few months before my cancer was diagnosed, and it did not show elevated antigen levels, which could have created the wrong impression that there was no cancer present. A rectal examination by a specialist proved necessary to confirm the diagnosis. I am grateful that my cancer was detected early and could be prevented from spreading beyond the prostate.”

He says that he carefully researched the disease and its treatment options available in South Africa. He was referred to Dr Conradie at Netcare Waterfall City Hospital and found the urologist's track record to be impeccable. “As a world renowned specialist with years of experience in the medical and urology fields I developed complete confidence in Dr Conradie,” he adds.

Loureiro also read up on the new robotic assisted technology and had no hesitation in choosing this option when a prostatectomy was recommended as the best form of treatment in his case. “It’s like choosing between a Michael Schumacher racing in a Ferrari or some other novice driver. Whom are you going to bet on?” he says.

Dr Conradie applauds Netcare for its initiative to bring the da Vinci technology to Johannesburg and Cape Town. “Netcare has made a major investment in advancing the field of urology in South Africa and the new robotic technology will assist in keeping the country abreast of international trends in the treatment of localised prostate cancer. By far the majority of prostatectomies in countries such as the United Sates and United Kingdom are now being performed robotically, which is an indication of how this technology is rapidly becoming the treatment of choice around the world. Netcare has also invested in an impressive training and support programme that has ensured that the specialist urologists who are using the technology in the two centres are expert in its use.”

Dr Conradie says that the da Vinci Si system enables surgeons to visualise the prostate and surrounding tissues three dimensionally and in high definition. This, and the robot’s highly manoeuvrable surgical ‘arms’ means that, in the hands of a well-trained surgeon, he or she has a high degree of control over what is a very intricate procedure, resulting in improved precision in cancer control and better clinical outcomes for patients.

As smaller incisions are required patients who have the surgery also tend to experience fewer complications. Some observers have likened using the system to learning a surgical video game, but here there are no margins for error. Hence, the need for doctors to be well trained and experienced in its use. In such hands, the da Vinci technology is proving a formidable surgical tool both in South Africa and around the world.

“The high precision means that we are better able to spare nerve bundles, ensuring that the nerves that control both erectile function and continence are better preserved. The result is that patients experience a faster return to urinary continence and normal erectile function. We surgeons also appreciate the fact that we can perform the surgery remotely from the comfort of a console, which means we are able to stay fresh and alert during procedures for longer periods of time,” concludes Dr Conradie.

Ends
Issued by : Martina Nicholson Associates (MNA) on behalf of Netcare
Contact : Martina Nicholson, Graeme Swinney, Sarah Beswick or Jillian Penaluna
Telephone : (011) 469 3016
Email : martina@mnapr.co.za, graeme@mnapr.co.za, sarah@mnapr.co.za or jillian@mnapr.co.za