In a review of 104 studies, representing almost 230 000 patients and published in the World Journal of Urology recently, researchers analysed the outcomes of robotic-assisted procedures compared to laparoscopic and open retropubic radical prostatectomies (removal of cancerous prostate).
The review looked at major complications, operative time, length of hospital stays, blood loss, transfusions, conversions, rate of post-operative erectile dysfunction and incontinence, cost and positive surgical margin (PSM) which indicates whether the entire extent of the cancer was extracted during the operation.
“For PSM and peri- and post-operative complications, [robotic surgery] demonstrated better results than [open surgery] and laparoscopic radical prostatectomy,” noted the report.
Urologist and robotic surgeon Dr Francois Duvenage said the results echoed the experience at The Urology Hospital, Pretoria. It is the first institution in Africa to obtain a robotic surgical system which has conducted over 1 300 procedures since 2013.
“Robotic-assisted surgery is well known to be minimally invasive with less side effects. This study indicates it may also be able to better control cancer. The aim of the operation is to remove the prostate and all the inherent and surrounding cancer and this research shows that robotic surgery is leading in this regard.”
The review is in line with other research on robotic surgery which shows improved erectile function and urinary continence compared to open surgery.
Just over 4% of all South African men will develop prostate cancer in their lifetime and an average five South African men die from prostate cancer every day.
In addition to prostatectomies, robotic surgery is offered at The Urology Hospital for partial nephrectomies, (removal of cancerous parts of the kidney) and cystectomies (removal of the bladder). It is the only specialised hospital of its kind in SA, comprising 23 urologists, 10 of whom are trained in robotic surgery – the highest concentration of robotic surgeons in the country.
