“Now, thanks to robotic surgery, it has become possible for vital nerves and urinary control muscles to be preserved during the operation procedure thanks to improved vision and precision, thereby lowering the risk of impotence and incontinence.”
When he is not practising at The Urology Hospital, Dr Coetzee also works as a Senior Consultant Urologist at the Department of Urology at the University of Pretoria where he is involved in the training of postgraduate students focusing on uro-oncology (the research and treatment of cancers and congenital abnormalities of the urinary systems of males, females and children) and reconstructive oncology (the reconstruction of the urinary tract, especially after cancer surgery, for example, in cases where a patient’s bladder is removed).
Prior to introducing this operating system in South Africa, patients had to undergo open abdominal or transperineal (surgery through the perineum) surgery to remove a cancerous prostate. Nerves and blood vessels controlling functions such as erectile function and urinary continence lie in close proximity to the prostate. Because these structures can often not be seen during an open operation, they often end up being inadvertently damaged during surgery, resulting in a loss of erectile function and urinary continence. In the past, patients were also left with large wounds that would impact on their mobility between four to six weeks post-surgery, experienced high levels of blood loss during the operation, had to undergo lengthy hospital stays of up to a week, and ran a 20% chance of becoming incontinent, and a 30% to 40% chance of becoming impotent. With robotic surgery these functions can be far better preserved, with up to 90% preservation of erectile function and 95% plus preservation of urinary continence.
“Now, thanks to robotic surgery, it has become possible for vital nerves and urinary control muscles to be preserved during the operation procedure thanks to improved vision and precision, thereby lowering the risk of impotence and incontinence.”
By using a robotic surgical system, which contains all the clinical and technical capabilities involved in traditional open surgery, as well as a high resolution camera and mechanical arms with surgical instruments attached to them, a surgeon is able to conduct the operation through a few tiny punctures. The mechanical arms are controlled by a surgeon, who is seated at a computer console that gives him a high definition (magnified times 10), 3D view of the area of surgery. The robot therefore operates as an instrument within the hands of a highly experienced surgeon, who has been trained to use this technology to offer his patient better and much-improved medical care.
The robotic surgical procedures that are currently conducted by Coetzee include:
In future, the removal of retroperitoneal lymph nodes in patients with testicular cancer for example will also be possible.