Robo-Op refines prostate surgery

Picture: File Treating prostate cancer through cutting the stomach in open surgery often left patients having to use catheters

Picture: File Treating prostate cancer through cutting the stomach in open surgery often left patients having to use catheters

Published Sep 28, 2017

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It used to be highly invasive surgery, immobilising a patient for 21 days in hospital, and with the painful sting of impotence and erectile dysfunction.

“There were long recuperation times because it was a big surgery,” Dr Hugo van der Merwe, a urologist at the Urology Hospital in Pretoria, said.

Treating prostate cancer through cutting the stomach in open surgery often left patients having to use catheters for a longer period of time, and in terrible pain lasting months from the scarring.

But that was before 2013.

Since then, prostate cancer patients eligible for surgery have had the option of undergoing robotic surgery using the Da Vinci Surgical System.

The R20 million system was introduced at the urology hospital in 2013, over a decade later than First World countries which had been using it since 1999. It is only available in five private hospitals across the country.

“We’ve seen patients become able to return to their normal environments a lot quicker and it’s allowed surgery to be a lot friendlier and much less invasive,” said Van der Merwe.

Four percent of South African men will develop prostate cancer in their lifetime and more than 4300 are newly diagnosed each year. Prostate cancer is receiving attention this month as September is Prostate Cancer Awareness month.

Prostate cancer occurs in a man’s prostate - a small walnut-shaped gland just below the bladder, that produces the seminal fluid that nourishes and transports sperm.

It surrounds the urethra (the tube that carries urine and semen through the penis and out of the body).

Prostate cancer is one of the most common types of cancer in men. It usually grows slowly and initially remains confined to the prostate gland, where it may not cause serious harm.

Its symptoms include:

* Frequent need to urinate, especially at night.

* Difficulty starting or stopping a stream of urine.

* A weak or interrupted urinary stream.

* Leaking of urine when laughing or coughing.

* Inability to urinate standing up.

* Painful or burning sensation during urination or ejaculation.

* Blood in urine or semen.

Although there are three broad approaches in treating prostate cancer, depending on how advanced the disease is, most patients present late for treatment, resulting in the need for surgical removal of the gland.

With the Da Vinci Surgical System, surgeons operate through a few small incisions. It features a magnified, 3D, high-definition vision system using tiny instruments that can bend and rotate at far greater angles than the human wrist. But the surgeon is still the one operating the system and performing the surgery.

“The main problem we have in the country is the low rates of early detection,” Van der Merwe said.

Urologists say using the latest technology to treat prostate cancer remainsy expensive, though, as patients still need to be admitted, pushing up costs.

To create awareness about

prostate cancer and the importance of regular checks by men, the Prostate Cancer Foundation is running a campaign, Suit Up September, calling on men and women to wear a suit on September 27, and to

purchase a “Suit Up September” sticker.

All funds raised will be used to support the education, awareness and research initiatives about prostate cancer.

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