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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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VoD cuts the cord in SA

Some 20% of South Africans who sign up for a subscription video on demand (SVOD) service such as Netflix or Showmax do so with the intention of cancelling their pay television subscription.

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That’s according to GfK’s international ViewScape survey*, which this year covers Africa (South Africa, Kenya and Nigeria) for the first time.

The study—which surveyed 1,250 people representative of urban South African adults with Internet access—shows that 90% of the country’s online adults today use at least one online video service and that just over half are paying to view digital online content. The average user spends around 7 hours and two minutes a day consuming video content, with broadcast television accounting for just 42% of the time South Africans spend in front of a screen.

Consumers in South Africa spend nearly as much of their daily viewing time – 39% of the total – watching free digital video sources such as YouTube and Facebook as they do on linear television. People aged 18 to 24 years spend more than eight hours a day watching video content as they tend to spend more time with free digital video than people above their age.

Says Benjamin Ballensiefen, managing director for Sub Sahara Africa at GfK: “The media industry is experiencing a revolution as digital platforms transform viewers’ video consumption behaviour. The GfK ViewScape study is one of the first to not only examine broadcast television consumption in Kenya, Nigeria and South Africa, but also to quantify how linear and online forms of content distribution fit together in the dynamic world of video consumption.”

The study finds that just over a third of South African adults are using streaming video on demand (SVOD) services, with only 16% of SVOD users subscribing to multiple services. Around 23% use per-pay-view platforms such as DSTV Box Office, while about 10% download pirated content from the Internet. Around 82% still sometimes watch content on disc-based media.

“Linear and non-linear television both play significant roles in South Africa’s video landscape, though disruption from digital players poses a growing threat to the incumbents,” says Molemo Moahloli, general manager for media research & regional business development at GfK Sub Sahara Africa. “Among most demographics, usage of paid online content is incremental to consumption of linear television, but there are signs that younger consumers are beginning to substitute SVOD for pay-television subscriptions.”

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New data rules raise business trust challenges

When the General Data Protection Regulation comes into effect on May 25th, financial services firms will face a new potential threat to their on-going challenges with building strong customer relationships, writes DARREL ORSMOND, Financial Services Industry Head at SAP Africa.

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The regulation – dubbed GDPR for short – is aimed at giving European citizens control back over their personal data. Any firm that creates, stores, manages or transfers personal information of an EU citizen can be held liable under the new regulation. Non-compliance is not an option: the fines are steep, with a maximum penalty of €20-million – or nearly R300-million – for transgressors.

GDPR marks a step toward improved individual rights over large corporates and states that prevents the latter from using and abusing personal information at their discretion. Considering the prevailing trust deficit – one global EY survey found that 60% of global consumers worry about hacking of bank accounts or bank cards, and 58% worry about the amount of personal and private data organisations have about them – the new regulation comes at an opportune time. But it is almost certain to cause disruption to normal business practices when implemented, and therein lies both a threat and an opportunity.

The fundamentals of trust

GDPR is set to tamper with two fundamental factors that can have a detrimental effect on the implicit trust between financial services providers and their customers: firstly, customers will suddenly be challenged to validate that what they thought companies were already doing – storing and managing their personal data in a manner that is respectful of their privacy – is actually happening. Secondly, the outbreak of stories relating to companies mistreating customer data or exposing customers due to security breaches will increase the chances that customers now seek tangible reassurance from their providers that their data is stored correctly.

The recent news of Facebook’s indiscriminate sharing of 50 million of its members’ personal data to an outside firm has not only led to public outcry but could cost the company $2-trillion in fines should the Federal Trade Commission choose to pursue the matter to its fullest extent. The matter of trust also extends beyond personal data: in EY’s 2016 Global Consumer Banking Survey, less than a third of respondents had complete trust that their banks were being transparent about fees and charges.

This is forcing companies to reconsider their role in building and maintaining trust with its customers. In any customer relationship, much is done based on implicit trust. A personal banking customer will enjoy a measure of familiarity that often provides them with some latitude – for example when applying for access to a new service or an overdraft facility – that can save them a lot of time and energy. Under GDPR and South Africa’s POPI act, this process is drastically complicated: banks may now be obliged to obtain permission to share customer data between different business units (for example because they are part of different legal entities and have not expressly received permission). A customer may now allow banks to use their personal data in risk scoring models, but prevent them from determining whether they qualify for private banking services.

What used to happen naturally within standard banking processes may be suddenly constrained by regulation, directly affecting the bank’s relationship with its customers, as well as its ability to upsell to existing customers.

The risk of compliance

Are we moving to an overly bureaucratic world where even the simplest action is subject to a string of onerous processes? Compliance officers are already embedded within every function in a typical financial services institution, as well as at management level. Often the reporting of risk processes sits outside formal line functions and end up going straight to the board. This can have a stifling effect on innovation, with potentially negative consequences for customer service.

A typical banking environment is already creaking under the weight of close to 100 acts, which makes it difficult to take the calculated risks needed to develop and launch innovative new banking products. Entire new industries could now emerge, focusing purely on the matter of compliance and associated litigation. GDPR already requires the services of Data Protection Officers, but the growing complexity of regulatory compliance could add a swathe of new job functions and disciplines. None of this points to the type of innovation that the modern titans of business are renowned for.

A three-step plan of action

So how must banks and other financial services firms respond? I would argue there are three main elements to successfully navigating the immediate impact of the new regulations:

Firstly, ensuring that the technologies you use to secure, manage and store personal data is sufficiently robust. Modern financial services providers have a wealth of customer data at their disposal, including unstructured data from non-traditional sources such as social media. The tools they use to process and safeguard this data needs to be able to withstand the threats posed by potential data breaches and malicious attacks.

Secondly, rethinking the core organisational processes governing their interactions with customers. This includes the internal measures for setting terms and conditions, how customers are informed of their intention to use their data, and how risk is assessed. A customer applying for medical insurance will disclose deeply personal information about themselves to the insurance provider: it is imperative the insurer provides reassurance that the customer’s data will be treated respectfully and with discretion and with their express permission.

Thirdly, financial services firms need to define a core set of principles for how they treat customers and what constitutes fair treatment. This should be an extension of a broader organisational focus on treating customers fairly, and can go some way to repairing the trust deficit between the financial services industry and the customers they serve.

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