array(1) { ["tipo"]=> int(27) } Robotic surgeries are minimally invasive procedures, where robotic arms make small incisions in patients and operate with precision using instruments accompanied by a camera.
According to the urologist, Matheus Miranda Paiva, robotic surgery brought a lot of delicacy, precision and high performance. He participated in the Jornal Enfoque program last Monday (22).
Paiva discussed how robotic prostate surgery occurs. “Traditional surgeries carried out in the past posed risks of bleeding and damage to the structures around the prostate in the nerves responsible for potency and continence, which can now be avoided.”
“With technology we improve methods”, he highlights, highlighting that the robot is nothing more than our connection with the robotic arms when dealing with the patient. “The surgeon places sensors in his hands, places his head inside a console and it feels like we are an ant in the patient’s belly. The movements are highly precise, with tremor, movement and delay filters and the surgeon becomes much more delicate”, he reveals.
The impact is big. He mentions that he has hands that are 28 centimeters long and that he carries a robot needle just 3 millimeters long. This ends up greatly minimizing the risk of surgical damage, mainly avoiding bleeding. “Our vision increases 10 to 40 times and this way we are able to preserve nerves and blood vessels when removing the prostate. Even in cases of advanced tumors, it is possible to remove it completely, with no neoplastic cells remaining in that patient”, says the doctor.
Patient
Paiva also highlights that we are all afraid of feeling pain when open surgery is offered, especially the incision and the delay in healing the cut. He states that the new method is carried out through small holes, measuring 7 to 8 mm, without the need for blood transfusions or long periods of hospital stay. “The patient can go home the next day”, he highlights, stating that many people sometimes do not understand the extent of the surgical work carried out. “Large tumors are gutted, highly complex surgeries are performed and, sometimes, the patient feels so good that the next day he wants to do physical activity”, he jokes.
The doctor reveals that the effectiveness of using the equipment is close to 100%. In the case of prostate surgery, which is the most common, urinary control after 3 months reaches around 95%.
Previously, a patient who had prostate surgery could experience urinary incontinence. “As prostate disease begins at the age of 60, 65, people at that age have a degree of sexual impotence, today it is clear that around 70% of these patients who were potent remain unchanged, which is very good” , supports
In cases of prostates with benign tumors, surgery with a robot only occurs with a volume between 80 and 100 g. For minor surgeries there are simpler techniques, prostate removal, TUR, and other more modern techniques. From 80 to 100 g, it is possible to remove the robot, taking it from inside the bladder, to stay away from nerves and noble structures, removing the prostate adenoma, a very simple surgery with quick recovery.
Exams
Regarding the age at which the prostate exam should take place, Paiva mentions that the Ministry of Health recommends rectal examination and PSA measurement from the age of 50. People with a family history, usually inheritance related to the father, should undergo examinations at age 40, or 10 years before the occurrence in their father.
For example, if the father had it at 55, he should look for it at 45. In general, about 10 years before the common population, just as black people should look for it 10 years earlier as they have an increased risk of prostate cancer.
People who only take the PSA and believe they are in good health are actually at risk. “Our American medical colleagues, a few years ago, had stated that touch made no difference, this confused a lot of people. Now we realize that after that the incidence of advanced prostate cancer increased greatly in the United States. This shows that prevention and early diagnosis is the best way”, he recommends.
Where to look?
Paiva states that part of this surgery is paid for by health plans. They cover what would be spent on a videolaparoscopy surgery, for example, such as hospitalization, patient food, materials, vacuum cleaners and coverage.
The patient only pays a fee for what is exclusively robotic. Hospitals do not charge rent for the use of the machine, but they charge for disposable material. Furthermore, it is worth remembering that Santa Casa de Santos is the only hospital in the Baixada Santista region that has a Robotic Center and qualified staff to carry out procedures using the most advanced surgical technology in the world.
Other surgeries
Regarding the possibility of performing other robotic surgeries, he comments that the equipment is very democratic and it can be used anywhere there is a cavity. For example, the head and neck itself can have surgery, the chest cavity, lung surgery, tumors of the chest, heart, abdomen, stomach, pancreas and intestine as well.
“Urological surgeries, which include kidneys, prostate, bladder, uterus and ovaries (in the case of the gynecologist), can all be operated on. We need the robot more in smaller cavities such as the male pelvis, which is super narrow and therefore requires the use of this technology.
In the case of a kidney tumor, located inside the organ and therefore difficult to detect, the use of the robot is essential. “We use ultrasound to locate the tumor, to define the exact location of the intervention to remove and reconstruct it. “It is curious that six months after the surgery, it is difficult to identify the place where the intervention took place due to the delicacy of the handling. The robot has become a great ally of medicine today.” highlights
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