Robotic surgery has been a breakthrough in modern surgical technology. Avoiding large incisions and reducing surgical trauma provides better clinical outcomes with faster patient recovery times, less pain, shorter hospital stay and a reduced risk of infection.
We interviewed Urologist Dr. Ignacio Moncada Iribarren, Head of the Urology Department at the Hospital Universitario Sanitas La Zarzuela and Director of the Sanitas Robotic Surgery Institute, the private center that performs the most robotic interventions in Spain and a training center where professionals come to learn new robotic techniques.
What urological pathologies are treated with robotic surgery?
The most common robotic intervention is radical prostatectomy, an operation to cure prostate cancer, but the indications are increasingly expanding. Thus, we perform radical cystectomies for bladder cancer with intracorporeal reconstruction of an intestinal bladder or partial nephrectomies in which we remove a kidney tumor while preserving the rest of the kidney and many other oncological and benign pathology procedures that benefit from minimally invasive access and millimetric precision.
What does the da Vinci robot offer?
The da Vinci robot is a very sophisticated and very safe surgical system. It allows us to perform minimally invasive surgery through small orifices but with great precision. With a 3-D magnified vision for the surgeon, with a scaled movement which suppresses tremor or sudden movements and with great mobility of the miniature scissors and forceps that are introduced, we can have enormous precision in what we remove and above all in what we want to preserve and not damage.
What are the advantages of robotic surgery?
Undoubtedly, the great beneficiary is the patient. If we look at the example of prostate cancer, robotic surgery makes it possible to remove the prostate without damaging the urinary sphincter, thus avoiding incontinence, or not damaging the nerves that conduct the nerve impulse to the penis, allowing a faster and better recovery of the erection.
What is the experience at the Hospital Sanitas La Zarzuela like?
At Hospital Universitario Sanitas La Zarzuela we have been using this modern technology for 5 years now, as part of Sanitas’ commitment to innovation and clinical excellence. Our experience in this time has been unbeatable, we have operated more than 500 patients with excellent clinical results. Our results in oncological control, percentage of continence and preservation of erectile function and above all patient satisfaction are comparable to those of the best hospitals in the world.
Soon we will have in Zarzuela robotic surgery through a single port, we will be able to perform complex surgery through a single incision of 2 cm; the instruments enter together and inside the abdomen are deployed to work effectively. In the longer term, robotics will allow us to perform telesurgery.
How are the sequelae of radical prostate surgery managed?
Incontinence and erectile dysfunction problems frequently occur after radical prostate surgery. This possibility is minimized with robotic surgery in a very significant way, however in the Department of Urology of Sanitas La Zarzuela we are experts in the correction of these sequelae and pioneers in the introduction of surgical techniques to correct both problems. Through the placement of mesh or artificial urinary sphincter in the case of incontinence and prosthetic implants in the case of erectile dysfunction; and very particularly the simultaneous implantation through a single small incision of both devices to solve both problems in a single operation. We receive patients from all over the world for this type of operations.