The Surgical Robot’s Vital Role in Helping CUH Save Lives

Prostate cancer is the most common non-cutaneous malignancy in men in Ireland. According to statistics from the Irish Cancer Society, it is a diagnosis that one in seven Irish people will receive in their lifetime.

Wherever and whoever you are, you’ll want to know that you or your loved ones will receive the best possible medical care should such a diagnosis arrive at your doorstep. For those in the Munster region, it is reassuring to know that Cork University Hospital (CUH) is a specialist cancer center with a quick-access prostate clinic.

The center was established in conjunction with the National Cancer Control Program (NCCP) to ensure that patients with suspected prostate cancer can be seen and treated quickly.

Robot-assisted prostatectomy has become a standard of surgical care in many parts of the world. At CUH, the da Vinci Xi Surgical System promises to save lives and improve patient outcomes for years to come.

The surgical team in block 8 (from left to right) Dr Colm Lane, consultant anaesthesiologist; Meera George, bedside nurse; Olga Kenny, bedside nurse; Bindu Mathew, CNM1; Maura O’Donoghue, CNM2; Mr Kevin O’Connor, consultant urologist, and Mohammed Hegazy, SPR urology. Photo: Denis Minihane

Of course, just because robot-assisted surgery for prostate cancer management has become a standard of surgical care doesn’t necessarily mean it’s the best option for all prostate cancer patients. prostate. If and what type of treatment might be warranted for such a patient is up to their senior medical team to decide.

Explaining how these decisions are made, Kevin O’Connor, consultant urologist at CUH, says: “Receiving a diagnosis of prostate cancer usually involves a patient seeing a GP first. They may present with bothersome urinary symptoms, or for a routine or wellness exam.

“The GP can then discuss with the patient the pros and cons of a blood test that measures the amount of prostate-specific antigen (PSA) in the blood.

“If this test is done and the results warrant it, the GP may refer the patient to the CUH rapid access prostate clinic. There they are seen and evaluated by myself or my colleague Frank O’Brien.

The evaluation may lead to the patient having an MRI.

“Some are then referred to their GP with the result that there is nothing there. Others are referred for further testing, which could include a prostate biopsy which would be done at the CUH Orchid Follow-up by a consultant radiologist.

The Da Vinci Xi robot in the theater at University Hospital Cork.
The Da Vinci Xi robot in the theater at University Hospital Cork.

All patient results are then reviewed and if prostate cancer is diagnosed, the case is discussed at a Multidisciplinary Team (MDT) meeting. Mr O’Connor says some of the specialists attending could include surgeons, pathologists, radiologists, medical oncologists, radiation oncologists and specialist nurses.

“After this meeting, the patient is seen again in the clinic, so options can be discussed,” he says. “These may include surgery to remove the prostate, radiation therapy or active surveillance.

“The dilemma for us is choosing which ones need to be treated and which ones can be safely monitored.”

Mr O’Connor explains that the latter can be considered when a patient has a low-grade cancer, or one that is unlikely to evolve over many years: “In these cases, the patient can be checked every six months to detect signs of change. The disease may not progress. But if so, radiation therapy or surgery may be offered.

“The da Vinci Xi Surgical System facilitates surgery in several ways, including improved magnification, better surgeon ergonomics, and greater technical ease in suturing in a tight space deep in the abdomen. This translates to better patient outcomes in relation to less pain and faster recovery.

“At CUH, we have performed over 200 cases of robotic prostatectomy. The nurses, anesthesiologists and all other team members have all gone to great lengths to successfully become proficient with what initially would have been new robotic technology difficult.Great credit must go to them.

“Each of them works so hard to ensure that patients receive the best possible care, from the moment they arrive at CUH until they are cared for by the wonderful post-op nursing team.”

Ask yourself whether open or robotic surgery is likely to be best for a patient with prostate cancer, and you’re asking the wrong question.

O’Connor puts it this way: “The primary determinant of patient outcome is the surgeon, not the tool. It is the experience of the surgeon, not the tool that matters most. Although the robot is beneficial, patients with the most experienced surgeons in high-volume centers will fare better in terms of cancer cure and associated side effects such as post-surgical impotence and post-surgery impotence. ‘urinary incontinence.

A few years ago, Mr O’Connor and his colleagues used a da Vinci X robotic instrument, which belonged to Cork University Maternity Hospital (CUMH).

“This robot was transported to CUH once a week for use in prostate surgery,” he says. “In July of last year, CUH Charity purchased a robot for CUH.”

How important is it for CUH to have the da Vinci Xi surgical robot and other new technologies on site for patients in Munster?

“In providing good health care, we need to push the boundaries. If we stand still, we fall behind. Ireland’s population will increase dramatically as people are living much longer and patient expectations are higher than before. We must constantly move forward to meet the demand.

Michael Nason, CEO of CUH Charity.
Michael Nason, CEO of CUH Charity.

Michael Nason, CEO of CUH Charity, is passionate about fundraising for University Hospital Cork.

Mr. O’Connor is full of praise for his CUH colleagues and the CUH Charity team. “So many people are working so hard to push this thing forward,” he says. “CUH Charity has made the purchase of vital robotic instruments for CUH a priority.

“The involvement of CUH Charity has been essential in equipping CUH with the only da Vinci Xi surgical instrument we have, and the simulator which is used for surgery and surgical training in the hospital. This technology has also benefited the patients of my colo-rectal colleagues, Mr. Shane Kileen and Mr. Peadar Waters.

“Everyone using the technology at CUH has gone overseas to train and become proficient in using the technology and have returned to Ireland to use it.”

In conversation, the phrase “live longer and healthier” is often repeated by Michael Nason. Obviously, helping CUH patients do just that is integral to the mission of CUH Charity and indeed to the man himself.

It is a noble mission, a mission in which we can all play a part.

Michael Nason urges those of us who can to: “Try to take better care of your health, so that all available resources can be spent on those of us who need them most.” He also urges those of us who can to assist CUH Charity in its fundraising efforts and help keep the hospital equipped with vital high-tech equipment to help save lives.

We can do this knowing that every donation will be used to help ensure CUH patients have access to the best medical devices.

To donate today, please click: www.cuhcharity.ie/donate/

Christine E. Phillips