The twenty-first da Vinci robot system has just been installed in the UK, which is good news for the increasing number of patients who now have access to this form of surgery. Eighteen of the machines are in the NHS, with the rest in private hospitals.
The da Vinci robot facilitates radical prostatectomy especially, but can also be used for the treatment of bladder, kidney, cardiac and gynaecological cancers. Radical prostatectomy with the da Vinci robot is easier to learn and more “intuitive” to perform than conventional laparoscopy (keyhole surgery). It is during the learning curve of all techniques that mishaps most often occur – so prostate surgery should be safer now.
Urologists at two of America’s leading cancer hospitals, Memorial Sloane Kettering in New York and Johns Hopkins in Baltimore, have demonstrated that with either robot-assisted, laparoscopic or traditional “open” radical prostatectomy, the greater the experience of the surgeon, the better the outcomes – certainly in terms of the risk of cancer recurrence, and likely also in terms of restoration of sexual function (Vickers et al, Lancet Oncol. 2009 May; 10(5):437-9).
The units which have the most experience with the da Vinci machine in the UK are The Prostate Centre; Guy’s Hospital, London; Addenbrooke’s Hospital, Cambridge; and The Royal Marsden Hospital, London.