Dr. López Costea, head of the Urology Service at Hospital Quirónsalud Barcelona and a specialist in urologic robotic surgery, explains that technologies such as 3D and Augmented Reality make it possible to improve the patient experience and the short- and long-term results in cases of urologic cancer.
Hospital Quirónsalud Barcelona was the first center to use robotic surgery to treat prostate cancer in 2011. To date it has successfully performed 130 operations on urological cancers (prostate, bladder and kidney), although the professionals who make up the Advanced Robotic Surgery Unit have accumulated more than 500 cases performed in other centers, with oncological and functional results in line with the majority of international reference centers in this field.
It is this experience and trajectory, recognized worldwide and backed by the good results achieved, that has led to the introduction of new robotic surgery technologies to facilitate the operation and further reduce the after-effects. This intervention is less invasive and reduces postoperative sequelae: less painkillers after the operation, less blood loss in the operating room, fewer days of hospitalization; at the same time it leads to an improvement in the treatment of urological cancer and a reduction in the adverse effects associated with surgery.
With ultrasound or 3D imaging, the aim is to complement the results of robotic surgery and to add elements that provide safety in the planning of the intervention and in the surgery itself, facilitating the surgeon’s maneuvers. As explained by Dr. Miguel Ángel López Costea, head of the Advanced Robotic Surgery and Urology Unit at Hospital Quirónsalud Barcelona, “the use of ultrasound (ultrasound), which helps us in the localization of renal tumors during partial robotic surgery, or the growing use of 3D technologies in the surgical planning of complex renal tumors due to their location within the kidney, are applications in robotic surgery that are increasingly used”. “In the not too distant future, Augmented Reality technology will have its application in the intraoperative management of different tumors, and single-port robotic surgeries with flexible instruments will be widely used in a relatively short time, providing less invasiveness without reducing vision or ease of movement to develop the surgical technique,” concludes the doctor.
Importance of experience in robotic surgery applied to urology.
Prostate cancer is the disease where robotic surgery is most commonly applied. The reason is that, when performed by teams with long experience and trajectory, it improves oncological and functional results, both in the control of urinary incontinence and in the reduction of erectile dysfunction associated with conventional surgery, especially in young patients who want to have a better quality of life. The figures for erectile dysfunction two years after the operation, as well as those for urinary continence, are comparable to those of the main centers of excellence worldwide.
In kidney cancer there has been an increase in recent years in the indications for partial kidney surgery, due to a greater number of cases diagnosed very early, thanks to the generalization of imaging scans (ultrasound, computed tomography, resonance). This has allowed early diagnosis of tumors smaller than 4-5cm.
On the other hand, the increase in life expectancy of the population with the consequent renal “aging” due to pathologies such as diabetes or arterial hypertension has led to an increase in the indication for partial surgeries, with the consequent preservation of renal tissue without compromising the oncologic results of the patients. Renal robotic surgery provides a better view of the operative field and better results, as well as an improvement in postoperative renal function.
With regard to bladder cancer surgery, it also offers clear advantages, both in removing the bladder while preserving erectile function and in urinary diversion. Robotic surgery is also widely used in the surgical resolution of some malformative pathologies of the urinary system.
Special technology applied to Urology
Hospital Quirónsalud Barcelona has a Da Vinci robotic surgical platform, which combines 3D and augmented vision of the surgical field with others such as the possibility of operating through a single, minimal incision (single-port surgery), or the possibility of performing robotic surgery with different medical teams operating at the same time.