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Thanks to robotic surgeries, lifesaving operations are now being performed by medical surgeons at Tygerberg Hospital with far fewer risks than ever before.
This was evident during a visit to the operating room at the hospital on Friday last week, where one patient was undergoing robotic surgery for colon cancer. The media was given a first-hand opportunity to see just how surgeons make use of the da Vinci robotic surgery programme, which was introduced two years ago at the hospital. Another machine is in use at Groote Schuur Hospital in Observatory. These two machines were purchased at a combined cost of R80 million in 2021.
Before the visit to the operating room, provincial minister of health and wellness, Prof Nomafrench Mbombo, addressed journalists, providing an update on the progress of robotic surgeries carried out in the Western Cape since their inception, and the impact it has had on the public healthcare’s services.
“We are doing good. The total number of operations that has happened since is 603, which is quite a lot,” says Mbombo.
She added that with the help of this type of surgery, they can now minimise the use of resources. “For example, after the robotic surgery the patient does not have to go to ICU (Intensive Care Unit), compared to previously. We also use minimal, to no blood transfusion,” says Mbombo.
The types of common cancers treated with the help of the robotic machine include gynaecology, urology and colorectal surgery.
“We are the first public hospital to have this intervention, these robots. The machine is expensive, but the benefits and the impact of these benefits are far higher. The patient now stays for five days, without the robots it can be up to two weeks, so a bed opens for another patient, and we are also saving on food costs. There is a whole lot of savings, even though we do not perform so many operations,” Mbombo says.
Surgeon
One of the surgeons who make use of the machine, Dr Claire Warden, a colorectal surgeon at Groote Schuur Hospital, explained how her operations on the robotic machine works.
“This is very intricate technology, so what we have done is pick our most difficult cases with colorectal surgery, which is particularly rectal cancer. This is where we operate in the pelvis, things are very close together, very important blood vessels and nerves. And you want to do very precise surgery. So those are the cases we have picked to do this type of operation on, to use the robot for its preciseness, its steadiness. Those are the cases we tackle,” she says.
Asked about the difference between then and now, Warden says it is worlds apart. “We have learned a lot; we have grown in terms of the cases that we can take on. The machine, we have learned, is incredibly steady, it has got incredible magnification, and it is really helping us tackle more challenging rectal cancers. Before we took perhaps the simpler rectal cancers, now we tackle more of these cases and bigger intricate cases.”
Warden says at Groote Schuur Hospital they have dealt with all disciplines, colorectal, acute care, urology, gynaecology, and that they have nearly reached 200 cases.
Patient
Leon Koks (64) is one of those who have benefitted from the da Vinci robotic machine.
“I was diagnosed in 2022 with colon cancer and was admitted the same year. I was then told that I was the first patient to undergo the robotic surgery. At first, I was a bit hesitant, but the doctor, Claire Warden, kept me up to date as to the procedure, and what was going to take place. She reassured me, calmed me down and I felt very confident.
“The recovery time was quick, two days later I was asked to get up and walk, which is what I did. Three days later I was discharged, and I just started walking at home, increasing the distances which I did for about two weeks. Thereafter I resumed my training as a runner and in 2023 I completed my first Comrades Marathon. The recovery time was very good, very quick. And I am fine, there are no kickbacks.”
He says he feels good and have been ever since.
“The family was a bit nervous at first, but also very supportive. They stood with me, my sons, wife and immediate family. My message to other men, I would advise you to listen to the doctor. Things will work out for you. Be confident, be yourself, believe it can be done,” Koks says.
Health activist
Demaris Kiewiets, a health activist, has praises for the robotic machine.
“The impact of robotics on services in a hospital context is the fact that a robotic patient frees up a bed for a trauma emergency, somebody who might be shot or might be in a critical accident, so instead of a nurse being assigned to a robotic patient, she is then assigned to a trauma bed.
“In high care, where the robotic patient is transferred to, they do not need that kind of care that the ICU needs, and that is the advantage and ripple effects of robotic surgery, instead of a surgery that takes long term care – 14 days in ICU, where it is only five and a half days in high care.
“Your nurse driven service, around a patient that needs ICU or a theatre, is much less than that of robotics. The impact of robotics is that it reduces the costs when it comes to theatre operations, ICU use and patient care. The patient does not need long term care. Your ICU patient goes to a ward, this patient goes form high care, home and does not occupy a bed, so the bed occupancy also gets reduced through robotic surgery,” Kiewiets says.
There are currently approximately 1 500 beds available in Tygerberg Hospital.
