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Irish clinic that has technology of the future
22 November 2009
It may sound like an illusory character from a science fiction novel, but the robotic device that is performing prostate surgery every week at the Galway Clinic is very real indeed.
Later this month, the Da Vinci robotic arm - the only one of its kind in Ireland - will celebrate its second birthday. A total of 75 radical prostatectomies have been performed by the robotic arm since its arrival in Galway in 2007,and the futuristic medical device is currently averaging at least one operation each week.
‘‘The overall expectations of the surgeons and patients at the Galway Clinic have been surpassed in the past two years," said David Bouchier Hayes, the consultant urologist who has pioneered the development of robotic surgery in Ireland with colleague Paddy O’Malley.
‘‘This is the only robotic device performing prostatectomies on the is land of Ireland, and we have people coming to us from all over the country.
‘‘They come because they have heard of the advantages that are associated with robotic surgery."
Instead of the lengthy incision that is the primary characteristic of open surgery prostatectomy, the robotic device requires only a number of small incisions for its life-saving work.
At its most simplistic level, the robotic arm is an extension of the arms of the surgeon, who directs the device from a computer console that provides a 3Dviewof the area being operated on.
The camera attached to the robotic arm offers a magnification of ten, allowing the surgeon to operate with greater dexterity and precision.
‘‘The best way to compare it is that it is like watching the operation on a widescreen television, instead of a portable set," said Bouchier-Hayes. ‘‘The huge magnification allows the surgeon to undertake manoeuvres that are more refined and delicate. We can make highly precise movements within small operating areas.
‘‘Blood loss is very significantly reduced, while blood transfusion rates are less than 5 per cent of those seen in open surgery.
‘‘Recovery rates are also dramatically improved, and we have patients who are now going home on the third morning.
‘‘Patients are also reporting a much earlier return to full post-operative continence, so the advantages are enormous."
It is no coincidence that the Galway Clinic has set the pace in Ireland for prostate surgery.
Bouchier-Hayes and O’Malley are both fellows of the Australian Institute of Robotic Surgery, and the only two urologists in Ireland fully trained in robotic surgery.
Bouchier-Hayes was a member of the medical team that conducted Australia’s first robotic prostatectomy in 2003 at the Royal Melbourne Hospital, under the direction of Professor Tony Costello.
O’Malley later joined his Irish colleague in Australia, and both men received four years of training in the use of robotic surgical devices.
Robotic surgery is the dominant method of treating prostate cancer in the US, where the technology was originally developed by Nasa for operating on astronauts in space.
The technology was further advanced by the US Department of Defense to provide surgery to injured soldiers on the battlefield, thereby eliminating the need to send surgeons to the front line.
The purchase of the Da Vinci robot by the Galway Clinic was the single largest investment in a surgical instrument in Irish history. It cost €2.2million to buy and install, and the funds were provided by 20 businesspeople in Galway who gave personal guarantees for the investment.
Prostate cancer is the most prevalent male cancer in Ireland today, and November is prostate cancer awareness month. The most recent data from the National Cancer Register of Ireland (NCRI ) showed that 2,536 new cases of prostate cancer were diagnosed in 2007. Irish men have a one in nine chance of contracting the illness.
The NCRI’s predictions for the future are even more worrying, with a 275 per cent increase expected in the next decade. This would translate into 3,768 cases in 2020. But survival rates are good, with 69 per cent of those diagnosed living for another five years or more.
Early detection is crucial, however, and men over the age of 50 are advised to undergo a screening for prostate cancer, especially if there is a history of the illness in their families.
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