A highly-specialised urogynaecological procedure has been performed for the first time in South African private healthcare by means of robotic-assisted surgery.
This is according to private hospital group Netcare, which says it ushers in a new era for the treatment of urogynaecological and colorectal conditions in the country.
Professor Stephen Jeffrey, a urogynaecologist practising at Netcare Christiaan Barnard Memorial Hospital, says the versatile da Vinci robotic system, which was installed at the hospital in 2014, has been highly successful in treating numerous urological conditions.
He adds it was recently used in the first robotic-assisted cardiothoracic surgery in Southern Africa.
Now, the technology is once again at the forefront of medical advancements, with Jeffrey having recently conducted the first robotic-assisted sacrocolpopexy in a private healthcare facility.
According to the professor, sacrocolpopexy is done to correct pelvic organ prolapse, a fairly common condition affecting approximately 10% to 15% of women.
He explains that pelvic organ prolapse occurs with the weakening of certain muscles supporting the vagina, uterus, cervix, bladder, urethra, intestines and rectum.
“Pelvic organ prolapse can affect one or more of these organs, resulting in general feelings of discomfort, as well as bladder and bowel dysfunction. This can seriously impact the quality of life of those affected, with consequences to their physical and sexual health.
“Pelvic prolapse tends to be more common in women because of the strong link with childbirth, though it can occur in men and is associated with ageing and extreme weight-bearing activities over an extended period of time. Constipation and being overweight are risk factors for pelvic prolapse.”
He explains the da Vinci robotic system takes surgery into an enlarged 3D context, providing an immersive surgical experience.
“When you conduct the surgery from the console, you become one with your surgical instrument in a virtual sense. This is the greatest paradigm shift for me as a surgeon who has for many years been doing laparoscopic, or keyhole surgery. The robotics and visuals of this particular system are truly transformational in optimising accuracy,” notes Jeffrey.
“While there are a number of options for the correction of pelvic prolapse and colorectal conditions, including open surgery and keyhole surgery, the da Vinci offers benefits that are quite unmatched in any other type of modality and is by far the least invasive way to address these issues.
“With the ability to operate through an even smaller and more precise incision in the abdomen than can be done in keyhole surgery, we are able to achieve better nerve preservation, fewer sutures, reduced post-operative pain, less time in hospital and expedited healing. With other forms of surgery, a patient would require a lengthy recovery period of up to six weeks but with the da Vinci, they can resume normal activities again within two to three weeks,” says Jeffrey.
According to Dr Tim Forgan, a colorectal surgeon, president of the South African Colorectal Society, and part of the team at Netcare Christiaan Barnard Memorial Hospital, an increasing number of people stand to benefit from the level of intervention made possible by robotic-assisted surgery.
“When it comes to colorectal cancers, we are unfortunately seeing a rapid increase in incidence, with colon cancer now being the third most common cancer in South Africa. Predictions are that current numbers will increase two- to threefold over the next 20 years. This is largely attributable to lifestyle-related issues, such as diets that are high in animal protein and fat, and low in fibre,” says Forgan.
“In much the same way that people tend to avoid the subject of pelvic prolapse, there is not enough conversation around colon and rectal issues, which really is a tragedy when preventative measures can be taken and when world-class technologies, such as the da Vinci robotic system, are available in our country. Creating greater awareness is hugely important in tackling these issues as a society.”
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