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Robotic-assisted surgery successfully used to treat various urinary tract cancers

Introduction of da Vinci robotic surgical technology “a resounding success”

Wednesday, February 3 2016
The introduction of the da Vinci robotic programme at Netcare hospitals in late 2014 has been an outstanding success, and the urologists who have been trained on the state-of-the-art system are using it to assist in an increasing variety of groundbreaking surgeries.

This is according to Jacques du Plessis, managing director of the Netcare hospital division, who added that the da Vinci robotic technology which was initially introduced at Netcare Waterfall City Hospital in Midrand and Netcare Christiaan Barnard Memorial Hospital in Cape Town has been so successful, particularly in the treatment of various forms of urinary tract cancers, that Netcare has decided to install a third da Vinci system at Netcare uMhlanga Hospital to serve patients in KwaZulu-Natal.

“Our programme initially focused on prostatectomies and more than 304 of these intricate procedures have already been successfully completed at the two Netcare hospitals,” adds Du Plessis who was speaking ahead of World Cancer Day, 4 February. “Just like elsewhere in the world, robotic-assisted surgery is rapidly becoming the gold standard in the surgical treatment of localised prostate cancer here in South Africa,” he says.

“However, we were always aware of the technology’s immense capabilities and intended it to be used for other applications in disciplines such as urology, gynaecology and oncology. The urologists who have been trained in the da Vinci system have fully embraced this technology and they have already started applying the robotic-assisted technology in kidney and bladder surgery. They are making a significant contribution in optimising patient outcomes and improving the quality of life for Netcare’s patients. Indeed, they are now making South African medical history with the technology on an ongoing basis.”

“A robotic-assisted pyleoplasty, the surgical reconstruction of the renal pelvis section of the kidney, was for example recently undertaken on a 32-year-old woman. The operation was performed by urologist, Dr Anesh Naidoo, at Netcare Christiaan Barnard Memorial Hospital in Cape Town.”

Commenting on the procedure Dr Naidoo, who practises at Netcare Blaauwberg Hospital, said: “The patient was diagnosed with pelvi-ureteric junction obstruction, which is an abnormality that causes an obstruction of the flow of urine from the renal pelvis. With the obstruction cleared and the kidney successfully drained and decompressed, the patient recovered so well that she was discharged from hospital just two days after the operation.”

“This is one of the great benefits to patient of us using this technology; it allows us to perform surgeries through small keyhole incisions in the skin, which is less traumatic to the patient than open surgery which requires much larger incisions. In addition, it allows us to perform such a surgery much more quickly and with much more accuracy than a laparoscopic procedure, which means there is a reduced chance of complications.”

Netcare’s da Vinci technology was also successfully used in three other new applications recently. In November 2015 29-year-old Chantelle Gouws became the first person in South Africa to undergo a partial nephrectomy, an organ-preserving excision of a cancerous tumour from a kidney, with the aid of robotic-assisted surgery.

The procedure was performed by urologist, Dr Marius Conradie, at Netcare Waterfall City Hospital. Gouws was also the first woman in South Africa to undergo a procedure using the da Vinci robotic surgical system.

On the same day and at the same hospital, urologist Dr Johan Venter whose consulting rooms are at Netcare Pretoria East Hospital, performed a total nephrectomy, the complete removal of a diseased kidney, on another patient, 53-year-old Kevin Murphy. It was only the second nephrectomy done at a Netcare hospital with the aid of the robotic system; the first such procedure in South Africa having been undertaken by Dr Conradie in April 2015.

In addition, 64-year-old Jacob Venter underwent successful robotic-assisted surgery to remove his bladder, prostate gland, and pelvic lymph nodes at the hospital late in October 2015, the second such surgery to be undertaken in South Africa to treat cancer by means of the technology.

Dr Naidoo adds that robotic technology, which was initially conceived to remotely operate on astronauts in space, is exceptionally versatile. “Remarkably, it can be used to perform surgeries remotely with an operator situated thousands of kilometres away from the patient. In the future this may well prove beneficial for patients in more remote locations on our vast continent.”

“It is important to note, however, that this robotic technology does not perform surgery on its own; rather it is controlled by a skilled surgical team. One of the strengths of Netcare’s robotics programme is that the company has invested considerable resources into the training of surgeons and introduced the technology in a carefully considered, phased approach.”

He explains that the da Vinci technology provides the surgeon, who controls the surgery from a separate console, with a greater range of movement and steadiness of hand during surgery than can be achieved with the human hand alone, which is especially important in complex procedures. The surgeon is able to see the areas within the body, where the surgery is done, in the finest detail thanks to the 3D high-definition technology which is built into the system.

“We are able to work within finer margins and perform procedures much more accurately. This effectively means that we are able to remove diseased organs and tissue, and spare surrounding tissue and nerves better. In other words, we are able to meaningfully improve outcomes for our patients,” says Dr Naidoo.

Chantelle Gouws says she has been impressed at how quickly she recovered after her partial nephrectomy. “I was discharged just three days after the surgery and have experienced no pain since. A week afterwards, I felt so good that I wanted to swim, but my mother begged me not to.”

Kevin Murphy recovered well after Dr Venter successfully removed his cancerous kidney, and was discharged after only two days in hospital.

Jacob Venter is feeling better than he has done in years following the procedure to remove his cancerous bladder, lymph nodes and prostate. “He was in hospital for only three days, and was back at work in a week. All indications are that the cancer was prevented from spreading,” says Dr Venter.

According to Du Plessis, the third Netcare da Vinci Si system will be installed at Netcare uMhlanga Hospital soon and will be operational by the middle of 2016 once the specialists who will be using it have undergone the strict training programme.

“Considering the outstanding patient outcomes that have already been achieved with the da Vinci robotic technology at our hospitals in Johannesburg and Cape Town, its installation at Netcare uMhlanga Hospital is an exciting development for medicine in KwaZulu-Natal and will no doubt be welcomed by doctors and patients in the province alike,” concludes Du Plessis.

Ends

Issued by: Martina Nicholson Associates (MNA) on behalf of Netcare
Contact : Martina Nicholson, Graeme Swinney, Devereaux Morkel or Meggan Saville
Telephone: (011) 469 3016
Email: martina@mnapr.co.za, graeme@mnapr.co.za, devereaux@mnapr.co.za or meggan@mnapr.co.za or meggan@mnapr.co.za

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