First partial nephrectomy with aid of robotic-assisted technology a complete success
Friday, 6 November 2015
Chantelle Gouws yesterday became the first person in South Africa to undergo a partial nephrectomy using da Vinci robotic-assisted technology. The organ-preserving excision of a cancerous tumour from her kidney was done at Netcare’s Waterfall City Hospital in Midrand, Johannesburg.
The 29-year-old from Springs also became the first woman to undergo a procedure using the da Vinci robotic surgical system in South Africa.
“I was nervous before I knew what was wrong with me. Now I’m not nervous at all. I have a really, really good doctor and was quite surprised when I found out my procedure would be a double first,” Gouws said, from her hospital bed shortly before her operation.
“It is amazing to know that medical technology has progressed so much. I’m now very calm and comfortable about the procedure because I know Dr Conradie will remove all of the tumour accurately,” added Gouws.
Her surgeon, urologist Dr MC Conradie, said doing a partial nephrectomy was an extremely intricate and exacting procedure.
“There’s a number of blood vessels involved in the reconstruction of the urinary tract. Any mistake and the patient could bleed to death on the operating table,” he said.
Gouws’ tumour was diagnosed after an ovarian cyst burst about two months ago while she was at work. The cyst had gone undetected, as she had not been seeing her gynaecologist regularly. During an ultrasound examination by her gynaecologist the golf ball-sized mass in her right kidney was incidentally discovered.
Up until now urologists have been using the highly sophisticated technology, which was installed at Netcare Waterfall City and Netcare Christiaan Barnard Memorial Hospital to operate on men, mainly for the surgical removal of the prostate gland.
The system consists of a console where the surgeon sits, peering into a screen, using foot pedals and hand controls to remotely operate the surgical instruments attached to four robotic arms on a second console at the operating table.
Controlled by the surgeon at the console, the robotic arms do the cutting, clamping and cauterising with far greater flexibility and precision than is possible with human hands.
Unlike traditional surgery, da Vinci robotic-assisted procedures are minimally invasive. The instruments are inserted through small incisions.
“With this technology we can view the magnified organs, blood vessels and surrounding tissue in 3D, so that the surgery can be performed much more accurate,” said Dr Conradie
During the surgery Dr Conradie used an ultrasound probe to determine the extent of the tumour, to make sure they remove all of it. It was an ‘angry red thing’, about 4cm long, on top of the kidney, which he successfully excised.
“It operation went extremely well,” Dr Conradie said afterwards.
Gouws is expected to be in high care for a day and will thereafter be transferred to a general ward for two days, after which she will be discharged from hospital. She will be back at work in about one week to ten days.
Gouws does not have children, only a “loving boyfriend”. She said Dr Conradie had told her having children should not be a problem, but that they should first do the procedure and then see what the outlook was.
Dr Conradie said the success rate of da Vinci procedures was much higher and recovery time much shorter compared to traditional surgery. The procedure itself was also faster.
In another first, also on Thursday, urologist Dr Johan Venter who practises at Netcare Pretoria East Hospital performed his first nephrectomy, the complete removal of a kidney, on another patient also at Netcare Waterfall City Hospital. It was only the second nephrectomy done at a Netcare hospital with the da Vinci system.
“A complete success,” said Dr Venter after he removed 53-year-old Kevin Murphy’s right kidney, along with the fat and surrounding tissue in an operation lasting nearly three hours.
He used da Vinci technology to perform the procedure, but was unable to take the organ out through one of the small incisions made for the robotic arms, and had to make a larger incision for this purpose.
About two weeks ago Murphy noticed urine in his blood. After a visit to his doctor and some tests, the facilities manager was told he had a tumour in his kidney.
“I was devastated, I wasn’t in a happy space. I took it very hard at first,” Murphy said from his bed before the procedure on Thursday morning.
He said it was difficult coming to terms with having cancer and the realisation that he was going to lose part of his body. “I am, however, very confident in Dr Venter’s ability and the advanced technology he’s using,” he said.
Article date: 6 November 2015