Robotic Prostatectomy


Email Raji.Kooner@svha.org.au or call 02 8382 6980 for a confidential appointment.

It’s very interesting how I was always drawn to this technology.

In 1992, when the robot had been out for two years, I visited the American Urological Conference, and I tended the booth for Intuitive every day.

I’d actually convinced them to bring the robot to Sydney, and convinced Mani Menon, who was the father of robotic surgery, to come over and train us.

Unfortunately, that didn’t work out.

So, during the next few years I was always really interested in robotic surgery.

I kept in touch with the company, and fortunately we were very, very lucky in that the cardiothoracic surgeons were able to obtain the robot with the use of their donors.

John Davis is a principal donor, and was behind all this and I was very lucky and privileged to be in a position where I could start the robotic program.

I was chosen to lead it, pioneer it.

There was a lot of work and effort going into it at the start; we spent a long time at home watching videos, role playing it with the assistants and the nurses, and went through a lot of dummy cases before we did the first case.

I think I was very, very lucky in that I’d done a lot of laparoscopic work first, and this was a prostatectomy, so it was the same steps but a much more sophisticated bit of equipment.

I did the first case1.

I did 70% of the cases in the first year2.

I was also privileged to train other surgeons and assistants with this procedure.

I’m really happy to see that a lot of the urologists now have switched over to robot assisted surgeries, and it’s clear that this is the way of the future.

We have now performed over 2000 cases, I’m very pleased to say that I performed a large amount of these personally.

Studies have shown that you have to do over 200 cases to get excellent outcomes3, and fortunately I’m above that figure but I do believe that we had a low learning curve because of my experience in laparoscopic surgery.

The reason in Australia that there aren’t more robots around, I believe, is because of the cost of the robotic system.

You really need to have someone who helps the hospital donation to get the robot, and also there’s a significant learning curve initially when you start.

So, I’ve been very, very fortunate to be in a privileged position, and I’m really lucky and I really have to thank the cardiothoracic department, and the donors who bought the robot.

References

1. Man's kidney removed by robot (October 14, 2007) - The Sunday Telegraph - https://www.dailytelegraph.com.au/news/nsw/robot-removes-kidney/news-story/661e98f5b14efdb9ebd83dc54a1aacd8
2. A. Al-Sameraaii, Avi Raman, Chisum Yuen, R. Kooner - Robotically-assisted laparoscopic pyeloplasty (RALP). Utilisation of the robotic 4(th) arm in dismembered pyeloplasty - a review of the first 9 cases in NSW - Conference: 62nd Annual Scientific Meeting.. - Volume: 103
3. Patel, V. & Samavedi, S. Nat. Rev. Urol. 11, 140–141 (2014); doi:10.1038/nrurol.2014.10