First time a modern Da Vinci robot was applied in 1998. Today this surgical system is used for performing surgeries in Germany and all over the world. Currently there are more than 52 000 surgeries in prostate cancer performed by Da Vinci method. The first surgery assisted by Da Vinci robot lasted 420 minutes. Nowadays such surgeries in Germany take only 120-180 minutes thanks to the technological improvements and many years of practice.
8 biggest German clinics offer Da Vinci prostatectomy treatment (among them the Clinical Center of Friedrichshafen, Berlin Charité Clinic, Heidelberg University clinic and the others)
Nowadays prostate cancer removal (radical prostatectomy) is the most efficient method of treatment for this type of cancer. Prostatectomy possesses an advantage over radiation therapy: during da Vinci prostatectomy the doctor can detect the areas of prostate affected by cancer with maximum precision; moreover, da Vinci prostatectomy does not damage healthy cells. The prostate removal can be conducted either as a traditional surgical operation or as da Vinci prostatectomy.
Traditional surgical operation (cutting into the abdomen or perineal cavity and removing the prostate with a scalpel) can result in serious consequences like urinary incontinence and impotence, because there exists a risk of damaging the nerve tracts responsible for erection (on each side of the prostate) and muscles responsible for continence during the prostate removal procedure.
Unlike other methods of prostate cancer treatment, da Vinci prostatectomy is a laporoscopic surgery (done without cutting into the abdomen or perineal cavity). It is conducted by a surgical robot under the guidance of a human surgeon. The da Vinci robot can enhance the precision of da Vinci prostatectomy and, as a result, reduce the risk of complications for the patient. The cost of surgery: from 12.000 €.
Thanks to the development of “Da Vinci robot surgeon” a new category of surgeries appeared in medical practice. It is called robot-assisted laparoscopic surgery. Da Vinci robot allows performing small skin incisions with minimal traumatic effect on the surrounding tissues. It provides a 3-D image of the surgical area and arrange maximally precise moves of surgical instruments.
Da Vinci surgery is considered by doctors in Germany as a perfect one for serious urologic reconstructive surgeries, such as radical prostatectomy. Da Vinci technology helps to spare prostate nerve terminals and preserve continence and sexual function.
Da Vinci robot in Germany: field of use
- radical prostatectomy (total prostate removal in case of malignant tumor),
- kidney tumor resection,
- kidney pelvis plastic surgery,
Da Vinci surgical system
The system consists of a surgical console and robotized assistant for surgeries.
The console of the Da Vinci system:
- The urologist’s computer work field
- Managing surgery instruments using two special handles, precise replication of human hand moves.
- Optical 3-D- system provides 10x detailed zooming of the surgical field.
An operating assistant:
- Urologic assistant’s working place from the patient’s side
- Managing camera and instruments during a surgery
The robot provides to patients:
- Minimal hospital stay period
- Quick rehabilitation after a surgery
- Minimal painfulness
- Low risk of infection
- Minimal blood loss, low need in blood transfusion
- Small scars
- Quick continence restoration
- Better capabilities of prostate nerves restoration
- Big chances of potency preservation with the aim of Da Vinci robot system
Da Vinci robot offers surgeons:
- Lower fatigability
- Comfortable position
- Optimal visibility of pelvic organs
- Optical 3D-image
- 10x zooming
- Freedom of manipulations during a surgery
Precise instruments (as opposed to scalpel) reaching only several centimeters in size are used to conduct robotic prostatectomy. Five small incisions of less than 1 cm are made in the lower part of the stomach to get to the prostate. Three da Vinci prostatectomy instruments and two tubes with tiny video cameras are inserted into the incisions. These video cameras show 3D image with 15-20X zoom, which increases precision in movement and decreases the risk of postoperative complications. Besides, da Vinci prostatectomy instruments can make a multidirectional 90-degree bend, thus being as flexible as a human hand. Robotic hands copy the doctor’s movement with perfect precision and thoroughness.
Before a robot-assisted prostatectomy an abdominal cavity is carefully examined for spikes that can be a contradiction for the surgery. The frontal perineal coat is separated from the abdominal wall providing the full access to the small pelvis. Then, a surgeon carefully resects lymph glands in small pelvis area.
After this the prostate is separated from the surrounding connective tissue, muscle fibers and blood vessels. Using a special catheter a surgeon defines the junction between the prostatic gland and the bladder. The next step is separating the seminal vesicles and spermoducts located behind the bladder. Complete prostate removal requires renal ducts separation. After the surgery all resected materials are sent for histological examination to the laboratory.
Urology department of Friedrichshafen Clinic Centre offers a wide range of modern robot-assisted surgeries. More than 1500 qualified doctors and mid-level medical staff work in the clinic. In addition to in-patient and ambulatory treament, the clinic also does active university-based research in Tübingen University Clinic. This collaboration results in high scientific and technological level of treatment. New methods and types of treatment are constantly introduced. For example, in 2011 Friedrichshafen Clinic received a patent for using special robotics technology and, as a result, joined four major certified da Vinci centres in Germany. Each year about 1000 da Vinci surgeries are conducted in the urology department.
We can provide you with all the necessary information on da Vinci surgeries and help to make an appointment for initial consultation.