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Robots make their mark on SA surgery

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On Thursday (5 November), Chantelle Gouws became the first person in South Africa to undergo a partial nephrectomy using Da Vinci robotic-assisted technology.
The organ-preserving excision of a cancerous tumour from her kidney was done at Netcare’s Waterfall City Hospital in Midrand, Johannesburg.
The 29-year-old from Springs also became the first woman to undergo a procedure using the Da Vinci robotic surgical system in South Africa.
“I was nervous before I knew what was wrong with me. Now I’m not nervous at all. I have a really, really good doctor and was quite surprised when I found out my procedure would be a double first,” Gouws said, from her hospital bed shortly before her operation.
“It is amazing to know that medical technology has progressed so much. I’m now very calm and comfortable about the procedure because I know Dr Conradie will remove all of the tumour accurately.”
Her surgeon, urologist Dr Marius Conradie, says that doing a partial nephrectomy is an extremely intricate and exacting procedure. “There are a number of blood vessels involved in the reconstruction of the urinary tract. Any mistake and the patient could bleed to death on the operating table,” he says.
Gouws’ tumour was diagnosed after an ovarian cyst burst about two months ago while she was at work. During an ultrasound examination by her gynaecologist the golf ball-sized mass in her right kidney was incidentally discovered.
Up until now urologists have been using the highly sophisticated technology, which was installed at Netcare Waterfall City and Netcare Christiaan Barnard Memorial Hospital to operate on men, mainly for the surgical removal of the prostate gland.
The system consists of a console where the surgeon sits, peering into a screen, using foot pedals and hand controls to remotely operate the surgical instruments attached to four robotic arms on a second console at the operating table.
Controlled by the surgeon at the console, the robotic arms do the cutting, clamping and cauterising with far greater flexibility and precision than is possible with human hands.
Unlike traditional surgery, Da Vinci robotic-assisted procedures are minimally invasive. The instruments are inserted through small incisions.
“With this technology we can view the magnified organs, blood vessels and surrounding tissue in 3D, so that the surgery can be performed much more accurate,” says Dr Conradie.
During the surgery Dr Conradie used an ultrasound probe to determine the extent of the tumour, to make sure they removed te full 4cm tumour situated on the top of the kidney.
He adds that the success rate of da Vinci procedures is much higher and recovery time much shorter compared to traditional surgery. The procedure itself is also faster.
In another first, also on Thursday, urologist Dr Johan Venter who practises at Netcare Pretoria East Hospital performed his first nephrectomy, the complete removal of a kidney, on another patient also at Netcare Waterfall City Hospital. It was only the second nephrectomy done at a Netcare hospital with the Da Vinci system.
“It was a complete success,” said Dr Venter after he removed 53-year-old Kevin Murphy’s right kidney, along with the fat and surrounding tissue in an operation lasting nearly three hours.