Simultaneous rectal and prostate surgery with da Vinci

Posted on 13 June 2019

The da Vinci robotic system at Mediclinic Durbanville is once again in the spotlight, with what appears to be a world first on the system. During April, Dr Gawie Bruwer, urologist, and Dr Frikkie Rademan, surgeon, were able to simultaneously remove both rectal and prostate cancer from a 68 year old patient.

According to Dr Bruwer, this is extremely rare, “It is extremely rare to have simultaneous cancers such as this, and none that we know of has been reported in the world literature that have been removed together.” An added complication for this type of surgery is to anastomose both rectum and urinary tract in one operation, without developing adverse complications and breakdown. The precise and secure suture placing is now possible with the enhanced vision of the da Vinci Robot

The patient, a resident of Cape Town, presented with both cancers simultaneously and required intervention by both a urologist and surgeon. “Both organs were removed together in one sitting with the robot and both the bladder and colon re-united,” confirmed Dr Bruwer.

The da Vinci robotic system offers a broader range of movement in what is an exceptionally confined area. “The cancer was low down in the pelvis and as a result there is limited space to work,” explains Rademan, “This is where the robot brings more precision and access during the complicated procedure. We had no experience doing this complicated surgery together and learned a great deal for future cases.

“The histology shows complete removal of both cancers and there is no need for chemo or radiation therapy,” says Dr Rademan. While traditional surgery (without the use of the robot) provides the same prognosis, Dr Rademan indicates that the patient’s recovery is advanced in terms of hospital stay, return to normal routine as well as the return of bladder and sexual function.

Dr Bruwer highlights just what the da Vinci surgery means to a patient, “Firstly these surgeries could be performed together, which reduces theatre time and cost to the patient, but also enabled us to spare both urinary and fecal continence.”

The da Vinci robot has been at Mediclinic Durbanville for several years, with a number of surgeons being accredited on the system. Both Dr Bruwer and Dr Rademan attended a significant amount of training to safely perform surgery with the system. “In my time working on the da Vinci, I am convinced that the training and mentoring has been worth it. Reduced blood loss during the procedure, accelerated recovery times and the quality of life after the nerve sparing precision of the robot, are all significant factors when I discuss the options with my patients,” says Dr Bruwer.

“I am exceptionally proud of the work being done by the specialists at Mediclinic Durbanville, and this appears to be the first reported incidence of this dual surgery on the da Vinci. This is a feat that is not only significant for our hospital – but more importantly the innovation is providing the best possible clinical outcomes for our patients,” says Christine Taylor, Hospital General Manager Mediclinic Durbanville.

For more about the da Vinci robot watch this video…

Read more about the da Vinci robotic system at Mediclinic below:

Surgeons Perform First-In-SA Robotic Adrenalectomy Surgery

New technology gives prostate cancer patients cutting-edge surgical options

SA’s youngest robotic surgeon explains the benefits of technology

Another first for da Vinci robot at Mediclinic Durbanville

Da Vinci Surgical system