Modern solutions in urology not only for men - new generation surgical robot in Piaseczno

At the Uro.pl Polish Center for Advanced Urology, operating as part of St. Anne's Hospital in Piaseczno, the fourth-generation Da Vinci robot has replaced its earlier version. To date, surgeons there (as of 2021) have performed more than 700 robot-assisted surgeries, 95 percent of which involved removal of the prostate for cancer. The remaining 5 percent were procedures such as organ-saving removal of a kidney tumor, bladder surgery for cancer, and urinary reconstruction procedures.

Robotic surgeries in urology have been used worldwide for more than 20 years. They are used for precise and minimally invasive treatment of urinary tract diseases, including prostate cancer. Robot-assisted surgery enables the operator to perform precise and complex surgical procedures and translates into faster patient recovery.

Fourth-generation robot sees better

The fourth generation of the Da Vici robot, compared to the previous version used at the Uro.pl Polish Center for Advanced Urology, provides better vision. Meanwhile, thanks to the ability to insert instruments from different sides, it is easier to reach different organs. For this reason, the palette of possible surgeries expands to include procedures of multiple organs simultaneously or procedures of anatomically extensive organs, as well as urogynecological surgeries.

Thus, soon in the Piaseczno center robotic methods will be used to carry out operations on diseases of the genitourinary system in women to eliminate such disorders and dysfunctions as prolapse of the reproductive organs and incontinence or too frequent urination as a result. In addition, oncological procedures will be performed to remove tumors from women's urinary and genital organs.

Robot-assisted surgery spares tissues not affected by the disease. - This is because the robot operates with much smaller instruments than a surgeon would in traditional surgery. In addition, their tips are movable in all directions, just like a human hand and wrist, so they allow unlimited maneuvering. They are controlled by the surgeon, who sees the operated organs and surrounding structures under magnification on a console. The image is three-dimensional and allows one to look at everything from different sides. This makes all kinds of procedures performed with a precision unattainable with classical or even laparoscopic surgery," says Dr. Marek Zawadzki, leader and co-founder of the Uro.pl Polish Center for Advanced Urology.

The robotic arms can perform the full spectrum of movements, just like a surgeon's hand, but with a precision unavailable to humans and without the tremor that is a drawback of the human hand. Therefore, all kinds of complications after surgery occur much less frequently. - In the days before robots, we used to tell patients that a common consequence of prostate removal was incontinence. At the moment, the likelihood of this affliction is only 10 percent of cases, and it usually passes quickly. This has to do with the possibility of preserving the nerves in the immediate vicinity of the removed organ, and this also preserves sexual performance. So the patient not only stays in the hospital for a shorter time, but also has a better quality of life after the operation," explains Dr. Damian Sujecki, a urologist from Dr. Marek Zawadzki's team.

The operations in Piaseczno are performed by a team of 7 urologists. - Each of us has undergone training and obtained a license to operate using the robot," explains Dr. Przemyslaw Zugaj, deputy leader of the Uro.pl Polish Center for Advanced Urology. He adds that the number of procedures performed allows all surgeons to maintain their skills. Their minimum number per doctor has been set by the National Health Fund at 50 per year, which, given the demand from patients, the Piaseczno center does not have the slightest problem with realizing.

Individually tailored treatment

Uro.pl's Polish Center for Advanced Urology also provides diagnostic services. In addition to traditional fusion biopsy, the center, in cooperation with the Quadia MRI center, uses MRI, in which biopsy is performed in bore (i.e., inside the MRI machine). The use of a micro ultrasound machine allows for precise imaging (29Mhz vs. 9Mhz), providing a diagnostic method with high accuracy.

- The ability to perform three diagnostic methods allows us to accurately localize prostate cancer. This makes it possible for us to choose the right treatment method for the patient. As a rule, we propose several options, which we consider together with the patient. Thanks to this approach, we do not always have to apply the same treatment procedure to different degrees of the disease, its location in the prostate gland and the patient's preferences. Our arsenal includes several focal treatment techniques (i.e., destroying the cancer without removing the prostate), such as cryotherapy, nano-knife, HIFU or the use of a robotic system in cases requiring radical treatment, Dr. Zawadzki explains.

In addition, Uro.co.uk has recently acquired a video urodynamics device, which allows for a very accurate diagnosis of urinary function in men and the anatomy of the bladder and urethra, as well as other organs in women. - We want to raise awareness that urologists have the skills and tools not only to treat men, but also women with urological and gynecological diseases, Dr. Zugaj concludes.

Source: press mar.