Robotic Urology Surgery
Dr Handmer has specific training in robotic surgery. Many patients want to know more about robotic surgery, and this page is intended to provide a brief overview.
Please remember that this information is general in nature, and may not apply to your specific medical situation. If in doubt, please discuss with Dr Handmer or his staff.
What is robotic surgery?
Robotic surgery in Urology involves the use of the daVinci Xi robotic surgical system. The robot operates under the direct control of Dr Handmer, and doesn’t move or make decisions itself unless directly commanded.
The robot provides 3D magnified vision, precise control of highly dexterous instruments and works through ‘ports’ which are placed in usually into the abdomen.
The robot can be used to perform many different procedures.
Rather than a specific procedure, you can think of the robot as a surgical tool – a very complicated tool – that can be used to achieve many different outcomes.
For example, in Newcastle, Dr Handmer frequently performs the following robotic procedures:
Robotic prostatectomy (aka robot prostate, robotic radical prostatectomy, RALP, RARP)
Where the prostate is removed with a surgical robot under the control of Dr Handmer, usually for prostate cancer, but sometimes for other conditions as well
Robotic partial nephrectomy
Where part of the kidney is removed with the surgical robot, usually for suspected cancer or an abnormal growth on the kidney
Where the kidney, and the ureter are removed together with the surgical robot, usually for cancer
Where the drainage system of the kidney is divided and re-joined using the surgical robot, usually to treat obstruction caused by PUJ obstruction (known as UPJ obstruction in some countries overseas)
Where the bladder is removed with the surgical robot (and sometimes the prostate/uterus/ovaries), in most cases, to treat advanced bladder cancer
How is robotic surgery different to keyhole surgery?
Robotic surgery is a form of keyhole ‘laparoscopic’ surgery and has all of the advantages of traditional keyhole surgery. Unlike pure laparoscopic surgery, the robotic instruments have tiny ‘wrists’ and are in the control of movable, very precise robot arms which act under the control of Dr Handmer, who can see the operative area in three dimensions.
What is recovery after robotic surgery like?
Almost all studies of robotic surgery in Urology demonstrate faster recovery, and a shorter time in hospital after surgery. Most studies show patients have less pain after robotic surgery. Of course, robotic surgery is still major surgery, and complications of major surgery can be unpredictable and significant.
However, you won’t be discharged before you are ready, and Dr Handmer will explain to you prior to, and after the operation, what your expected time in hospital (usually Lake Macquarie Private Hospital or Lingard Hospital, where both robotics in Newcastle NSW are located) will be, as there are many other things that can affect this.
What are the benefits of robotic surgery?
In addition to the typical benefits of a shorter length of stay in hospital and reduced postoperative pain, in the scientific literature, robotic surgery consistently has lower (or comparable) rates of major and minor complications to existing keyhole ‘laparoscopic’ and open surgery.
Some of these benefits identified in studies include: Lower rates of transfusion, lower risk of wound complications and infections, lower risk of urine leak into the abdomen.
There are some studies, including Australian studies, suggesting that robotic surgery may be associated with improved cancer outcomes (for example, reduced positive surgical margin rates with robotic vs open radical prostatectomy).
What are the risks of robotic surgery?
In the scientific literature, robotic surgery is consistently found to be as safe, or safer than traditional keyhole and open operations.
However, there are some specific risks to robotic surgery. These include risks of fluid swelling to the head, eyes and breathing tube with some patient positions. Your anaesthetist will assess your safety for surgery from a heart and lung perspective, including considerations such as positioning. Dr Handmer works with regular anaesthetists who routinely, and safely, anaesthetise patients for robotic procedures.
There is also the risk of robot device failure. This is extremely unusual as the robot has many in built backups (redundancies). However, in the unlikely event that the robot was to cease functioning during a procedure, if critical steps of the operation had already occurred, your surgery would be continued with traditional keyhole or open surgery, which Dr Handmer is also trained in.
Please discuss your specific medical condition with Dr Handmer or his staff. Please see further information about referrals above.