Robot-Assisted Surgery for Urologic Cancer
In 2012, robot-assisted surgery for prostate cancer received insurance coverage, marking a significant milestone. At our hospital, we took an innovative step forward by introducing the da Vinci system in 2011, even before insurance coverage was available.
This advanced technology has revolutionized prostate cancer surgery, drastically reducing blood loss compared to traditional open surgery and nearly eliminating the need for blood transfusions. Furthermore, it allows for highly precise suturing when connecting the bladder and urethra, deep within the pelvis (Fig. 1).
Our department has already performed over 800 cases of robot-assisted radical prostatectomy, providing stable and consistent results. For renal cancer, when the tumor is small, partial nephrectomy is performed to remove only the tumor with a margin of surrounding normal tissue, thereby preserving kidney function.
In this procedure, after the tumor is removed, the incised surface is sutured closed, and then the kidney tissue is sutured. Robot-assisted surgery reduces the duration of renal artery clamping compared to laparoscopic methods, enabling precise cutting and suturing (Fig. 2) and resulting in fewer postoperative complications. We conduct approximately 30 of these surgeries annually.
In cases of bladder cancer, where the bladder must be removed, the urinary tract is rerouted using a bowel segment. Robot-assisted total cystectomy significantly minimizes blood loss and is less invasive than open surgery, facilitating an earlier mobilization and food intake postoperatively. This approach is feasible even for patients over 80 years old, considering their overall health condition. Our department performs about 15 such surgeries each year. Additionally, we have incorporated robot-assisted nephrectomy and adrenalectomy into our practice.
Robot-Assisted Surgery for Benign Urological Diseases
For older women experiencing conditions like uterine, bladder, or rectal prolapse, we offer robot-assisted sacrocolpopexy. This procedure involves securing the vagina to the pelvis with a mesh to prevent the prolapse of pelvic organs. It not only reduces the operation time but also enhances postoperative recovery.
Moreover, we have introduced robot-assisted pyeloplasty for ureteropelvic junction obstruction. This technique involves removing a narrowed segment of the ureter and precisely suturing the renal pelvis and ureter together, ensuring effective resolution of the obstruction.