Radical Prostatectomy for Prostate Cancer
Robot-assisted Radical Prostatectomy (RARP) is the most common robotic procedure performed in Singapore, and worldwide. The da Vinci system, with its 10 times magnification and 3-dimensional (3D) camera system, is perfectly suited for deep pelvic surgery such as radical prostatectomy. The da Vinci Endowrist instrumentation allows the surgeon to perform the complex manoeuvres deep in the pelvis effortlessly. RARP is now offered as a standard treatment option for patients considering surgery for prostate cancer which is still confined to the prostate. It is a proven surgical approach which provides patients the benefits of minimally invasive surgery, low blood loss, short hospital stay and superior cancer control with excellent urinary continence outcomes. In fact, the track record for RARP for localised prostate cancer is so good that even patients with advanced prostate cancer can now undergo RARP. On average, patients are discharged after two days with a urinary catheter, which will be removed 1 week later in the clinic. Thereafter, patients can resume light exercise immediately, and return to work after 1 week.
Partial Nephrectomy for Kidney Cancer
In the modern era, patients found to have kidney cancer no longer have to get their kidney removed anymore. Urologists are moving towards kidney-sparing approaches for kidney cancers, known as partial nephrectomy. This is especially true in selected patients with chronic kidney disease or those with a single kidney. Partial nephrectomy in complex tumours is challenging with conventional laparoscopic approaches. In such cases, the da Vinci system allows for precise kidney tumour removal and rapid suturing of the defect in the kidney. In a large meta-analysis study of about 4,900 patients published by Dr Png and colleagues, Robot-assisted Partial Nephrectomy (RAPN) was shown to have superior outcomes compared to conventional laparoscopic approach.1 Patients are typically discharged 2 days after RAPN. They should avoid exercise for 2 weeks. Thereafter they can start light exercise and return to work.
Footnote: 1. Leow, Jeffrey & H. Heah, Nathaniel & L. Chang, Steven & Chong, Yew-Lam & Png, Keng-Siang. (2016). Outcomes After Robotic Versus Laparoscopic Partial Nephrectomy: An Updated Meta-Analysis of 4919 Patients. The Journal of Urology. 196. 10.1016/j. juro.2016.06.011.
