Robotic assisted surgery using the da Vinci Xi surgical system has recently been established at Netcare Pretoria East Hospital.
This robotic system is the first of its kind to be installed in the private sector in the country. The hospital is the fourth in the Netcare Group to use da Vinci technology for a range of surgical procedures.
“With the introduction of robotic assisted general and urological surgery at our hospital, and with plans to also offer robotic assisted procedures in more disciplines in future, more patients will now benefit from this sophisticated technology,” says Pieter Louw, GM of Netcare Pretoria East Hospital.
The da Vinci Xi system was installed at Netcare Pretoria East Hospital in April and the initial robotic surgical team comprising urologists Dr Johan Venter and Dr Paul Smit, and general surgeon Dr Michael Heyns will use this advanced surgical technology for prostate and colorectal cancers, including those involving pelvic lymphadenectomy, as well as for surgical procedures for inguinal hernia, and other colorectal, pelvic floor and renal conditions.
Dr Venter, who has been performing robotic assisted surgery at Netcare Waterfall City Hospital since 2015, where the first da Vinci system in a Netcare hospital was installed the previous year, says that in appropriate cases robotic assisted prostatectomies can completely remove localised cancerous tissue while preserving erectile function and urinary continence.
“This fourth-generation version of the robotic system offers even greater control and vision of the operating field, enabling us to operate with absolute precision. In the case of prostate surgery, this is crucial for nerve sparing and, ultimately, continence and potency retention,” Dr Venter says.
“The tiny instruments are more dexterous than the human hand and enable us to work at the exact location needed within the body without the need to interfere with healthy tissues to access the surgical site. The magnified, 3D imaging aspect of the robotic system allows us to see the fine nerves and tissues with much greater clarity and detail than human vision.”
Dr Smit, who is also experienced in robotic assisted urology procedures, adds that the da Vinci system is always operated by trained, robotic accredited specialists. Slender instruments enter the skin through four small punctures, far less invasively than is possible with traditional open and laparoscopic surgery.
“Robotic assisted surgery is not an option for all patients, however when indicated there are significant benefits to patients in terms of a shorter hospital stay and less post-operative pain,” Dr Smit points out.
“For men undergoing robotic assisted prostatectomies, not only are there lower complication rates and less blood loss, but there is also less discomfort and fewer days with a catheter required after the procedure,” he says.
“The robotic system allows good blood vessel control, and this is especially important in the case of complete and partial nephrectomies where time is especially critical. The precision of the robotic system enables us to suture and release the blood supply within a crucial 20-minute window with greater ease than is possible with the traditional open, as well as laparoscopic surgical approaches.”
Dr Heyns will be leading the introduction of robotic assisted general surgery alongside urological procedures at Netcare Pretoria East Hospital. “This broadens the options available to patients not only in Pretoria, but also those from neighbouring provinces.
“For people requiring a colorectal resection for cancer, one of the greatest advantages associated with da Vinci Xi is that we can access the area more readily. With the enhanced precision it allows, patients are far less likely to need a permanent colostomy.”
Robotic assisted sacrocolpopexy, or pelvic organ prolapse repair surgery, is also associated with shorter hospital stays, fewer surgical risks and less post-operative discomfort.
“In addition to Netcare Pretoria East and Netcare Waterfall City hospitals in Gauteng, robotic assisted surgery is also offered at Netcare Christiaan Barnard Hospital in Cape Town and Netcare Greenacres Hospital in Gqeberha. This advanced robotic technology at Netcare Pretoria East Hospital is adding to the list of robotic surgeries that are done within Netcare facilities,” Louw adds.