Robotic Surgery


Advanced surgical robotic technology introduced to Johannesburg and Cape Town

State-of-the-art system an important step forward for medicine in SA


Tuesday, 24 June 2014 Advanced da Vinci robotic technology that enables surgeons to perform highly intricate, minimally invasive surgical procedures has been introduced to Johannesburg and Cape Town for the very first time. Medical specialists are hailing this initiative by Netcare as an important step forward for medicine in South Africa.


The state-of-the-art da Vinci Si technology, which will initially be used to perform surgery on prostate cancer patients, has been installed at Netcare Waterfall City Hospital in Midrand and Netcare Christiaan Barnard Memorial Hospital in Cape Town. Jacques du Plessis, managing director of the Netcare hospital division, says, “The new technology is a major investment by our group in South African medicine and is driven by our commitment to continue creating an environment for our specialists to offer their patients the latest in prostate cancer treatment that have been proven internationally to enhance outcomes. Superb clinical outcomes are being achieved with the system, which is highly regarded is around the globe,” adds Du Plessis.


Significant benefits to patients

Dr Dave Bowden, a urologist at Netcare Christiaan Barnard Memorial Hospital in Cape Town, praised Netcare for showing the initiative to acquire the system. “This technology is internationally regarded as a huge step forward over the current surgical gold standard for the treatment of localised prostate cancer. Studies have shown that in the hands of a well trained surgeon, da Vinci robotic surgery delivers consistently good outcomes for patients compared to the more traditional forms of surgery for prostate cancer, and also results in fewer complications. It effectively allows the practiced surgeon to operate within finer margins, which means there is less chance of leaving any cancerous tissue behind, providing good cancer control.”


“In addition, the technology gives surgeons the ability to perform more accurate nerve-sparing prostatectomies, ensuring that the nerves that control erectile function are better preserved. The result is that patients experience a faster return to normal erectile function. Studies have also shown that patients have improved early outcomes from a urinary continence point of view,” adds Dr Bowden.


The technology offers a number of other advantages over both open and laparoscopic surgery. “It is a much less invasive form of surgery than open surgery, resulting in a shorter hospital stay and quicker recovery time, while patients experience reduced blood loss during surgery and reduced post-operative pain as smaller incisions are required. In addition there is much less need for blood transfusion and there is a lower risk of wound infection,” says Dr Marius Conradie, a urologist based at Netcare Waterfall City Hospital and one of the first four specialists who will be performing this type of surgery at the hospital.


“It provides the specialist with far superior three-dimensional, high definition visualisation of the prostate, surrounding tissue and neurovascular bundles than is possible with open or laparoscopic surgery. It allows the surgeon improved dexterity and a steadier ‘hand’ when performing the procedure. The technology translates the surgeon’s hand movements on the instruments on the console into corresponding movements of the robotic arm instruments inside the patient, which gives the surgeon excellent control in performing a wide range of motions,” Dr Conradie explains.


Professor Mohamed Haffejee, adjunct professor and academic head of the Division of Urology at the University of the Witwatersrand, who also practices at Netcare Milpark Hospital in Johannesburg, says there is a place for all the treatment options available for prostate cancer in South Africa, including open surgery, laparoscopic surgery and brachytherapy. However, Prof Haffejee believes the robotic technology is a much-needed addition to our armoury in the fight against prostate cancer as it offers patients who require a radical prostatectomy a treatment option that delivers better outcomes.


Worldwide increase in robotic surgery

The da Vinci system is powerful technology that is being used in an increasing number of different procedures around the world. It has, however, mainly been used in the field of urology to perform prostatectomies to treat prostate cancer, a procedure that requires great surgical precision. Some 80% of prostatectomies in United States are now being performed robotically, and the number of procedures completed with such technology is increasing significantly year-on-year throughout the world.


There are just under 2 900 da Vinci robotic systems installed in 54 countries. Some 1.5 million procedures have been completed since the first system was introduced in 2008, more than 500 000 of which were completed in 2013. This is a 16 to 17% increase in the number of procedures compared to 2012. Da Vinci is the only robotic surgical system to have been approved by the Food and Drug Administration (FDA) in the United States.


The da Vinci Si system consists of a surgeon’s console offering three-dimensional high definition display and a patient side cart featuring robotic arms with proprietary wristed instruments, which are controlled by the surgeon and improve the natural motion of the human hand.


The da Vinci system is not ’robotic’ in the sense that it performs surgery by itself. Rather it is enabling technology that is designed to assist the surgeon to perform more complex surgeries more accurately than were previously possible. The medical specialists who are to use it, therefore, must be accomplished surgeons and trained in the technology.


Seven urologists are initially being trained locally as well as in an accredited wet laboratory in Belgium, in the use of the system. The first live procedures will be performed under the watchful eye of an expert proctor from the United Kingdom at Netcare Waterfall City Hospital on 30 June and at Netcare Christiaan Barnard Memorial Hospital on 8 July.


Dr Conradie, Prof Haffejee, Dr Evangelos Apostoleris who practises at Netcare Olivedale Hospital and Dr Johan Venter from Netcare Pretoria East Hospital, have already completed all the training modules. Dr Bowden, Dr Anesh Naidoo from Netcare Blaauwberg Hospital and Dr André Naudé who is based in Cape Town, have recently completed their clinical training overseas.


Some 4 000 men are diagnosed with prostate cancer each year. Radical prostatectomy, which involves the removal of the prostate, is not necessary in all cases of prostate cancer. Indeed, each case differs and treatment will depend upon factors such as the type of cancer involved and how advanced the disease is. However, the specialists who will be using the da Vinci system believe that because of the many advantages that robotic surgery offers, it will soon go on to become the preferred option for prostatectomy in South Africa, as is the case internationally.  


 “Netcare is committed to quality patient care and we have, in the past year, invested a little more than

R1 billion in facility and technology enhancements at our hospitals across South Africa,” concludes Du Plessis.




Issued by:         Martina Nicholson Associates (MNA) on behalf of Netcare
Contact: Martina Nicholson
  Graeme Swinney
  Sarah Beswick
  Jillian Penaluna
Telephone: (011) 469 3016