Robotic da Vinci surgery first at Mediclinic Kloof

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A urologist with nearly 12 years of experience in robotic surgery is now using the da Vinci system at Mediclinic Kloof Hospital. 

The hospital’s new robotic programme launched in August with a successful robot-assisted prostatectomy.

The evolution of surgical techniques

The da Vinci robotic surgical system, now available at Mediclinic Kloof Hospital, offers several benefits, especially for prostate cancer surgery. It gives surgeons a clear view and better access to the pelvis, making complex procedures like prostate removal easier, says certified da Vinci robotic surgeon and urologist Dr Reinholdt Kusche.  

Laparoscopic surgery was developed to reduce the risks and recovery time associated with major surgery. Compared to open surgery, it leads to smaller wounds, less bleeding, reduced pain, faster mobility, and a quicker return to work. “Robotic surgery aims to further improve and refine the techniques used in minimally invasive surgery,” Dr Kusche says. Traditional laparoscopic surgery has certain limitations, such as restricted visibility in the surgical area and the way the operative field is displayed on screens in the operating room.

“Laparoscopic instruments operate through a single fixed point in the abdominal wall, with a long distance between the surgeon’s hands and the instrument tip, which can make precise movements difficult. There’s also limited manoeuvrability, and sometimes multiple assistants are needed to help with retraction and camera positioning. Robot-assisted surgery still allows for minimally invasive or keyhole procedures but overcomes many of these challenges.”

Advantages of the da Vinci system in proctectomies

The da Vinci robot helps reduce surgical risks by allowing for smaller, more precise movements. Its instruments move in three planes at the tip, enabling better control and gentler handling of delicate tissue.

The advanced 3D visual system also improves accuracy. “The da Vinci robot’s high-resolution, magnified view makes it easier to see fine structures like veins, arteries, and nerves clearly, which ensures greater accuracy while operating,” Dr Kusche explains. Several safety mechanisms are built into the robot, further minimising risk.  

“One of the biggest changes I’ve seen is the shorter hospital stay, which is a major benefit. With open prostate surgery, patients usually stayed in hospital for 7-10 days. Now, with robot-assisted surgery, most go home after just two nights.”

Having the da Vinci surgical system puts Mediclinic Kloof at the cutting edge of medical technology and lets them offer top-level care to patients. Dr Kusche believes the future of urological surgery, including kidney, bladder, and prostate cancer, as well as complex reconstructions, lies in robotic surgery. “With close to two decades of data on robotic surgery, we know the oncological outcomes are equivalent, with a lower risk of postoperative complications and an earlier recovery of erectile function and continence.”

A painless recovery

Jacobus Booyse was Dr Kusche’s first patient to undergo robotic surgery at Mediclinic Kloof. Having been diagnosed with prostate cancer, he chose the da Vinci procedure because he believed its benefits made it the best option for him. “It’s nerve saving, and since they don’t cut your pelvic muscles, your erectile function is generally not affected,” he says. “Everything went like it should have and my recovery was painless.”

Booyse was also mobile the day after the surgery. “You’re in high care after the operation but the next day I was in the general ward, and I could walk around as usual.”

“I have had some discomfort, especially with bladder control, but this was already an issue before the operation due to my prostate cancer,” Booyse says. This symptom can last up to 18 months after surgery, but he notes that the recovery time is still much shorter than it would have been with conventional laparoscopic surgery.

Now cancer-free, Booyse needs regular check-ups but is otherwise able to return to work and normal life. “I’m very glad the robotic surgery was available. I had read about it beforehand, but Dr Kusche explained everything clearly and made me feel confident in the decision.”