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Robot surgery begins in SA

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Chantelle Gouws has 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.

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,” added Gouws.

Her surgeon, urologist Dr Marius Conradie, said doing a partial nephrectomy was an extremely intricate and exacting procedure.

“There’s 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 said.

Gouws’ tumour was diagnosed after an ovarian cyst burst about two months ago while she was at work. The cyst had gone undetected, as she had not been seeing her gynaecologist regularly. 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,” said Dr Conradie.

During the surgery Dr Conradie used an ultrasound probe to determine the extent of the tumour, to make sure they remove all of it. It was an ‘angry red thing’, about 4cm long, on top of the kidney, which he successfully excised.

“It operation went extremely well,” Dr Conradie said afterwards.

Gouws is expected to be in high care for a day and will thereafter be transferred to a general ward for two days, after which she will be discharged from hospital. She will be back at work in about one week to ten days.

Gouws does not have children, only a “loving boyfriend”. She said Dr Conradie had told her having children should not be a problem, but that they should first do the procedure and then see what the outlook was.

Dr Conradie said the success rate of da Vinci procedures was much higher and recovery time much shorter compared to traditional surgery. The procedure itself was also faster.

 “I was devastated”

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.

“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.

He used da Vinci technology to perform the procedure, but was unable to take the organ out through one of the small incisions made for the robotic arms, and had to make a larger incision for this purpose.

About two weeks ago Murphy noticed urine in his blood. After a visit to his doctor and some tests, the facilities manager was told he had a tumour in his kidney.

“I was devastated, I wasn’t in a happy space. I took it very hard at first,” Murphy said from his bed before the procedure on Thursday morning.

He said it was difficult coming to terms with having cancer and the realisation that he was going to lose part of his body.

“I am, however, very confident in Dr Venter’s ability and the advanced technology he’s using,” he said.

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Online retail gets real

After decades of experience in selling online, retailers still seek out the secret of reaching the digital consumer, writes ARTHUR GOLDSTUCK.

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It’s been 23 years since the first pizza and the first bunch of flowers was sold online. One would think, after all this time, that retailers would know exactly what works, and exactly how the digital consumer thinks.

Yet, in shopping-mad South Africa, only 4% of adults regularly shop online. One could blame high data costs, low levels of tech-savviness, or lack of trust. However, that doesn’t explain why a population where more than a quarter of people have a debit or credit card and almost 40% of people use the Internet is staying away.

The new Online Retail in South Africa 2019 study, conducted by World Wide Worx with the support of Visa and Platinum Seed, reveals that growth is in fact healthy, but is still coming off a low base. This year, the total sale of retail products online is expected to pass the R14-billion mark, making up 1.4% of total retail.

This figure represents 25% growth over 2017, and comes after the same rate of growth was seen in 2017. At this rate, it is clear that online retail is going mainstream, driven by aggressive marketing, and new shopping channels like mobile shopping. 

But it is equally clear that not all retailers are getting it right. According to the study, the unwillingness of business to reinvest revenue in developing their online presence is one of the main barriers to long-term success. Only one in five companies surveyed invested more than 20% of their online turnover back into their online store. Over half invested less than 10% back.

On the surface, the industry looks healthy, as a surprisingly high 71% of online retailers surveyed say they are profitable. But this brings to mind the early days of Amazon.com, in 1996, when founder Jeff Bezos was asked when it would become profitable.

He declared that it would not be profitable for at least another five years. And if it did, he said, it would be in big trouble. He meant that it was so important for long-term sustainability that Amazon reinvest all its revenues in customer systems, that it could not afford to look for short-term profits.

According to the South African study, the single most critical factor in the success of online retail activities is customer service. A vast majority, 98% of respondents, regarded it as important. This positions customer service as the very heart of online retail. For Amazon, investment back into systems that would streamline customer service became the key to the world’s digital wallets.

In South Africa online still make up a small proportion of overall retail, but for the first time we see the promise of a broader range of businesses in terms of category, size, turnover and employee numbers. This is a sign that our local market is beginning to mature. 

Clothing and apparel is the fastest growing sector, but is also the sector with the highest turnover of businesses. It illustrates the dangers of a low barrier to entry: the survival rate of online stores in this sector is probably directly opposite to the ease of setting up an online apparel store.

A fast-growing category that was fairly low on the agenda in the past, alcohol, tobacco and vaping, has benefited from the increased online supply of vapes, juices and accessories. It also suggests that smoking bans, and the change in the legal status of marijuana during the survey, may have boosted demand. 

In the coming weeks, we can expect online retail to fall under the spotlight as never before. Black Friday, a shopping tradition imported “wholesale” from the United States, is expected to become the biggest online shopping day of the year in South Africa, as it is in the USA.

Initially, it was just a gimmick in South Africa, attempting to cash in on what was a purely American tradition of insane sales on the Friday after Thanksgiving Day, which occurs on the third Thursday of November every year. It is followed by Cyber Monday, making the entire weekend one of major promotions and great bargains.

It has grown every year in South Africa since its first introduction about six years ago, and last year it broke into the mainstream, with numerous high profile retailers embracing it, and many consumers experiencing it for the first time. 

It is now positioned as the prime bargain day of the year for consumers, and many wait in anticipation for it, as they do in the USA. Along with Cyber Monday, it provides an excuse for retailers to go all out in their marketing, and for consumers to storm the display shelves or web pages. South African shoppers, clearly, are easily enticed by bargains.

Word of mouth around Black Friday has also grown massively in the past two years, driven by both media and shoppers who have found ridiculous bargains. As news spreads that the most ridiculous of the bargains are to be had online, even those who were reticent of digital shopping will be tempted to convert.

The Online Retail in SA 2019 report has shown over the years that, as people become more experienced in using the Internet, their propensity to shop online increases. This is part of the World Wide Worx model known as the Digital Participation Curve. The key missing factor in the Curve is that most retailers do not know how to convert that propensity into actual online shopping behaviour. Black Friday will be one of the keys to conversion.

Carry on reading to find out about the online retailers of the year.

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Reliable satellite Internet?

MzansiSat, a satellite-Internet business, aims to beam Internet connections to places in South Africa which don’t have access to cabled and mobile network infrastructure, writes BRYAN TURNER.

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Stellenbosch-based MzansiSat promises to provide cheap wholesale Internet to Internet Service Providers for as little as R25 per Gigabyte. Providers who offer more expensive Internet services could benefit greatly from partnering with MzansiSat, says the company. 

“Using MzansiSat, we hope that we can carry over cost-savings benefits to the consumer,” says Victor Stephanopoli, MzansiSat chief operating officer.

The company, which has been spun off from StellSat, has been looking to increase its investor portfolio while it waits for spectrum approval. The additional investment will allow MzansiSat’s satellite to operate in more regions across Africa.

The MzansiSat satellite is being built by Thales Alenia Space, a French company which is also acting as technical partner to MzansiSat. In addition to building the satellite, Thales Alenia Space will also be assisting MzansiSat in coordinating the launch. The company intends to launch the satellite into the 56°E orbital slot in a geostationary orbit, which enables communication almost anywhere in Africa. The launch is expected to happen in 2022. 

The satellite will have 76 transponders, 48 of which will be Ku-band and 28 C-band. Ku-band is all about high-speed performance, while C-band deals with weather-resistance. The design intention is for customers of MzansiSat to choose between very cheap, reliable data and very fast, power-efficient data. 

C-band is an older technology, which makes bandwidth cheaper and almost never affected by rain but requires bigger dishes and slower bandwidth compared to Ku-band connections. On the other hand, Ku-band is faster, experiences less microwave interference, and requires less power to run – but is less reliable with bad weather conditions.

MzansiSat’s potential military applications are significant, due to the nature of the military being mobile and possibly in remote areas without connectivity.  Connectivity everywhere would be potentially be life-saving.

Consumers in remote areas will benefit, even though satellite is higher in latency than fibre and LTE connections. While this level of latency is high (a fifth of a second in theory), satellite connections are still adequate for browsing the Internet and watching online content. 

The Internet of Things (IoT) may see the benefits of satellite Internet before consumers do. The applications of IoT in agriculture are vast, from hydration sensors to soil nutrient testers, and can be realised with an Internet connection which is available in a remote area.

Stephanopoli says that e-learning in remote areas can also benefit from MzansiSat’s presence, as many school resources are becoming readily available online. 

“Through our network, the learning experience can be beamed into classrooms across the country to substitute or complement local resources within the South African schooling system.”

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