Robotics - Prostate and Kidney surgery
Robotic Assisted Laparoscopic Radical Prostatectomy (RALP)
Robotic prostatectomy is the newest and most advanced surgical option for the treatment of patients with localised prostate cancer and is available on the Gold Coast at the John Flynn Hospital.
Typically a patient who has undergone a radical prostatectomy using the da Vinci Surgical System can expect to leave hospital in just one to three days and return to normal activities within a week or two. Depending on your occupation you can expect to return to work between 1 and 4 weeks.
In the USA, roughly 80% of all radical prostatectomies are performed using this technology, where the robot replicates the surgeon’s hand. It has been used successfully in thousands of procedures worldwide. Our figures in Australia mimic what has happened in the USA with an increasing number of procedures being performed each year. A total of over 5000 robotic prostatectomies have been performed in Australia over 2000 robotic prostatectomies are now performed each year.
Robotic Assisted Partial Nephrectomy
In Kidney cancer the benefits of robotics magnification and precision are of even greater benefit. Dr Elmes will precisely remove only a cancerous lump whilst sparing the remaining healthy part of the kidney.
Wiith open surgery the patient would expect to remain in hospital for 7 days minimum and be put at high risk of chest infections / pneumonia. The recovery period has been greatly reduced by utilising robotic surgery.
Dr Elmes performed the first partial nephrectomy on the Gold Coast in 2013. The average time in hospital has been 2 nights.
It is especially important in patients with multifocal cancer or poor renal function.
As a result of da Vinci Robotic technology, da Vinci Robotic Partial Nephrectomy offers the following potential benefits:
Precise tumor removal and kidney reconstruction
Excellent chance of preserving the kidney, where indicated
Low rate of operative complications
Short hospital stay
Less blood loss
Robotic Assisted Pyeloplasty
Pyeloplasty is the surgical reconstruction of the renal pelvis (a part of the kidney) to drain and decompress the kidney. . The drainage pipe of a kidney includes the renal pelvis and the ureter which drain the urine from each kidney separately down to the bladder. In about 1/500 people there is a "bottle neck" at the beginning which prevents the easy drainage of urine and may effect kidney function. Often this is diagnosed at birth however a small portion of patients are only discovered later in life.
If you are reading this then it is likely that Dr Elmes has discussed this with you and that you will benefit from a robotic assisted pyeloplasty. As can be seen to the left of screen the narrowed pipe is opened up and healthy nearby tissue is used to recreate the natural width of the ureter, thus allow urine to drain unimpeded.
Most patients have only a small amount of pain with this advanced surgery as there are only a few small cuts in the skin, are able to eat upon waking and generally go home after an uneventful 2 night stay in hospital.
Robotic Enucleation of the prostate
In some men with severely enlarged BPH, surgery to remove a large section of prostate tissue from around the urethra is recommended. This helps with very enlarged prostates (eg, over 100 grams or so, about 3X normal size) or when BPH causes serious obstruction and problems such as urinary retention, infection, blood or stones (calculi) in the bladder, or kidney damage performed with the da Vinci® Surgical System in a minimally invasive procedure. Robotic techniques allow more precise removal of the inner part of the prostate with smaller incisions, reduced blood loss, less need for blood transfusion, less pain, shorter hospital stay (2-3 days), and faster overall recovery before a return to normal activities.
The exact approach and incision locations depend on the prostate's size and the patient's symptoms and other conditions. In most procedures, the adenoma (the abnormally enlarged portion of the prostate) near the urethra is carefully resected (removed). Then remaining parts of the gland are sewn back together to restore the normal prostate capsule.