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Before Isaacs Julius (52) went for his robotic prostate surgery earlier this month he told doctors at Groote Schuur Hospital he would like to see his wife and three children again post-operation.
And merely a day after his operation he was not only able to see his family, but was able to “walk around” too.
Julius, along with four other men, became the first patients to undergo robotic prostate surgeries in a state hospital in Africa. The historic surgeries took place between Monday 28 February and Wednesday 2 March.
The Da Vinci Xi fourth-generation robot, which is used in theatres at the hospital, can be used across a wide spectrum of minimally invasive surgical procedures and has been optimised for “complex, multi-quadrant surgeries”.
The goal of the system is to further advance the technology used in minimally invasive surgery for complex diseases and conditions in gynaecology, urology, cardiothoracic, colorectal and general surgeries.
Julius, an Atlantis resident, says he was diagnosed with prostate cancer more than a year ago.
“I woke up one morning and realised I was unable to pee, I was only dripping. I went to the private doctor and he gave me a letter for the day hospital and there I got a catheter. I was sent to New Somerset Hospital and there they discovered I had prostate cancer.”
He says he was transferred to Groote Schuur Hospital late last year where x-rays were done.
“I was told the operation might take place in two years’ time because the waiting list was long. They also inserted a catheter. Then one day I received an SMS that they now had this robot that will help with the operation, and they asked if I was willing to do the operation.”
Julius, who was unable to work for the past year, said he agreed without hesitation. He explained he had no complications post-operation.
“I was willing to have the operation. I was excited. My operation was done on the Wednesday, on Thursday I was able to help another patient and I was able to walk around. In a month’s time I will be able to return to work. I was without a job for more than a year. I am looking forward to my new life now. I feel happy now that the prostate has been removed. Soon the catheter will be removed and I will be able to pee again the way I used to.”
Another patient, Owen Appolis (61) from Tafelsig, Mitchell’s Plain, related he was shocked when doctors told him he had prostate cancer more than a year ago.
“At the beginning I didn’t know until I went to the clinic in Mitchell’s Plain, which gave me a letter to take to Groote Schuur Hospital. After some tests were done at the hospital the doctor there contacted me and told me he would like to see me. He told me I had prostate cancer. I was a bit shocked. After that I attended all my hospital appointments there.”
He said the idea of having robotic surgery did not scare him.
“I heard about the robot and it didn’t scare me. All I thought was the operation had to be performed, because if it wasn’t I may well die. I was admitted on Saturday 26 February, and the operation was done Tuesday 1 March. At 7 am I went into theatre, and by 4 pm I had woken up. It was worth having the operation as opposed to standing back and wondering. For me the best decision was to seek help.”
The father of three said he didn’t have any severe complications.
“The operation was a success. I was a bit dizzy; the doctors said my blood pressure had dropped. But on Wednesday morning I went I was placed in a ward and later that afternoon I was walking around and going to the toilet. By Thursday I felt much stronger.”
He describes his recovery as divine intervention.
“I feel healthy. I can only thank God because he carried us through. I would encourage others to go for the operation too – it is worth it. All the support I received has made me strong. And with the help of God I was made even stronger. My wife and family prayed for me. As patients we all prayed for one another.”
Dr Samkele Salukazana, a urologist and the robotic surgery coordinator at the hospital, says among the benefits of robotic surgeries is that patients’ blood loss is significantly reduced. He said with conventional surgery patients can lose up to 2 F of blood.
Salukazana says with robotic surgery the average blood loss for all patients was about 500 ml.
“I’m happy with how the operations went. I do open robotic prostate surgery, and for me I felt this operation was much easier using the robot. There was very clear differentiation of view translated to me seeing tissue better and seeing anatomy very well. And the fact that I am operating sitting down instead of standing for four hours doing an open procedure.”
Salukazana says due to the massive backlog with surgeries they did five procedures in three days. But he adds that going forward they will try and achieve about one case a week.
“I could preserve nerves for patients and preserve their sexual function, there were less issues with bleeding because I can see vessels very well. As much as the procedure took longer than usual, it was still a learning curve. But I was quite happy. We are looking forward to doing more and more patients.”
He said patients didn’t experience much pain post operation.
“The requirements for pain medication were significantly reduced because it is minimally invasive, we use key whole surgery and the pods that we insert are smaller than the conventional laparoscopic scissor that we use.”
Dr Mark Wellmann, a urology registrar, says with the current blood shortage at the Western Cape Blood Service the reduced loss of blood during the surgery is a massive benefit.
“The post-operative stay is shortened literally by half. Because these were our first few cases, we kept them a bit longer than they needed to, we kept them two to three days. If they had the open procedure, it’s a much bigger operation and they would have stayed for a minimum of four to five days.”
Wellmann says the robot provides up to 10 times better magnification, which allows the surgeon to see structures a lot better and therefore not damage them.
He said says as a doctor training this was an exciting experience.
“The other thing that’s exciting for us as doctors that are in training is being able to see exactly what’s going on with the operation and in high definition. Whereas with conventional surgery it’s difficult to get to the prostate, it’s very deep down in the pelvis, so when the primary surgeon or the specialist does the operation it’s not always possible to see all the steps that they are doing. So it’s very exciting for us because we get to see what is happening, so the teaching is a lot better.”
Salukazana thanked management at the hospital who facilitated in getting the robot for the hospital.
