Two local surgeons have completed the specialised training for robotic assisted colorectal procedures with a visiting proctor of the European Academy of Robotic Colorectal Surgery at Netcare Waterfall City Hospital recently.
“We congratulate general and bariatric surgeon Dr Sudha Naidoo and general surgeon Dr Bhavesh Gordhan on becoming accredited da Vinci robotic surgeons, adding to our country’s medical expertise for the treatment of colorectal conditions,” says Jacques du Plessis, managing director of Netcare’s hospital division.
This application of the technology at Netcare Waterfall City Hospital is adding to the list of robotic surgery programmes established within Netcare facilities since the Group became one of the first South African private healthcare providers to purchase the da Vinci robotic surgical system in 2014.
“The introduction of colorectal robotic assisted surgery at Netcare Waterfall City Hospital is the latest discipline to bring the benefits of technologically advanced options to our patients, building on the orthopaedics, urology, urogynaecology and cardiothoracic robotic surgical programmes already well established within Netcare facilities.”
More dexterous than surgeon’s hands
Dr Gordhan and Dr Naidoo recently completed four colorectal procedures using the da Vinci robotic surgical system, with proctor and head of minimal access and robotic colorectal surgery at the European Academy of Robotic Colorectal Surgery (EARCS), Prof Amjad Pravaiz of Poole Hospital NHS Trust in the United Kingdom. According to the doctors, robotics in colorectal surgery promises to further enhance the benefits of minimally invasive options for treating rectal prolapse, diverticulitis, bowel blockages, colon cancer and other colon-related conditions in South Africa.
“As there are so many delicate and interconnected structures surrounding the colorectal area in a person’s body, the da Vinci Si system can be particularly helpful for certain intricate and highly complex surgical interventions. The slender, dexterous instruments enter the skin through several small punctures, far less invasively than is possible with traditional surgery and going beyond what the human hand can achieve,” Dr Gordhan adds.
The four surgeries performed included a low anterior resection for rectal cancer, sigmoidectomies for patients with complicated diverticular disease and a rectopexy to correct rectal prolapse. These procedures involve the lower end of the digestive tract, from the lower large intestine, including the rectum and to the anus.
The sigmoid colon is the lower section of the large intestine. Sometimes pockets form in a person’s sigmoid colon, which may become inflamed and lead to complications including intestinal obstructions, fistula and bleeding among others. Sigmoidectomy surgery removes some or all the sigmoid colon, and the remaining healthy colon is painstakingly reattached to restore bowel function.
In a low anterior resection operation, the part of the rectum affected by cancer is removed and the colon is carefully reattached to the healthy remaining rectum, which is the final section of the intestine before the anus. The third type of procedure performed was a rectopexy to correct rectal prolapse, a condition whereby the rectum is no longer supported by the internal connective tissues and descends to protrude through the anus.
“We are pleased to be able to extend the options for patients in need of such procedures. Internationally, da Vinci robotic assisted colorectal procedures are showing quicker recovery times and shorter hospital stays for many patients, which helps to minimise time off work and get people back to everyday life sooner,” Dr Naidoo says.
“There is also evidence that better outcomes can be achieved in preserving sexual and bladder function in robotic assisted pelvic surgery.”
Millions of safety checks in every procedure
“The da Vinci robotic system cannot do anything by itself but is designed as a tool assisting the surgeon to perform intricate surgeries within the body. It provides a three-dimensional high-definition view of the area being operated on, which we can magnify up to 10 times to see tiny structures much more clearly than the naked eye, for greater accuracy,” Dr Naidoo says.
“Throughout every procedure, the robotic system performs millions of automated safety checks as the surgeon’s movements are filtered so that even the tiniest normal hand tremor – generally unnoticeable to the human eye – is removed. My actions are seamlessly translated to the robotic arms, improving precision and accuracy during fine dissection around critical structures,” Dr Gordhan adds.
The advantages for patients associated with robotic assisted technology include improved long-term clinical outcomes and disease management, including a reduced recurrence of cancer and potential for complications such as anastomotic leak and unintended bowel damage. Many patients are also able to return to normal life sooner after robotic assisted colorectal procedures.
Jaco du Preez, general manager of Netcare Waterfall City Hospital, commended Dr Gordhan and Dr Naidoo for their dedication to enhancing the skills and tools available to treat uncomfortable and potentially life-threatening colorectal conditions.
“We are grateful to add this world-class option to the services available to our patients, and for the opportunity to host Prof Pravaiz. The knowledge and expertise shared will no doubt benefit many South Africans in the years to come,” Du Preez concludes.
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