Melkbosstrand doctor leads robotic-assisted surgery

From left, Dr Joel Dunny, patient Etienne Nel and Dr Johan Van der Merwe

Cardiovascular and thoracic surgeon Dr Johan van der Merwe, from Melkbosstrand, recently performed a robotic-assisted cardiothoracic surgery – hailed as a first for Africa by Netcare.

Cardiothoracic surgeons specialise in operating on the heart, lungs and other chest organs, and Dr van der Merwe has been doing this for the past decade.

But this was the first time he got help from a robot, called the da Vinci surgical system.

The surgery was done on 33-year-old, Etienne Nel, a former semi-professional electronic sports (e-sports) gamer, at the Netcare Christiaan Barnard Memorial Hospital, in June.

The da Vinci system lets the surgeon operate using a console from which he can control surgical instruments and a camera mounted in robotic arms attached to a separate unit. The system gives the surgeon highly magnified, 3D high-definition views of the surgical area.

The surgeon can use the system to make smaller, more precise incisions that reduce blood loss and the likelihood of the patient needing a transfusion.

Dr Van der Merwe said the da Vinci technology provided the surgeon with a greater range of movement and steadiness of hand during the surgery, which was important in complex procedures.

“It is important to note that the robotic technology is not able to do anything on its own. Rather it is a tool fully controlled by the skilled surgical team at all times,” he said.

Dr Van der Merwe said another cardiothoracic surgeon and lung specialist, visiting from the UK, Dr Joel Dunning, oversaw the procedure.

Dr Dunning said the robotic system worked differently from the way cardiothoracic surgeries were performed, traditionally.

“Many cardiothoracic procedures traditionally involve either sternotomy, that is, splitting of the breastbone to access the area for open surgery, or thoracotomy, where the chest is opened through the rib cage. This necessitates a lengthy recovery period often with significant discomfort for the patient. The use of robotics technology, however, allows for intricate procedures to be performed deep within the patient’s chest without the need for large incisions, splitting of the sternum or opening the chest through the rib cage,” he said.

According to Dr Dunning, international studies indicate that a robotic approach to cardiac and thoracic procedures, such as Mr Nel’s, or various forms of heart surgery and lung cancer procedures, tends to offer quicker recovery times on average when compared with open surgery.

Dr Van der Merwe said nerves and blood vessels in Mr Nel’s right arm had been pinched between his first right rib and collarbone.

“Instead of cutting above his collarbone through sensitive muscles, operating this minimally invasive procedure allowed us to gently remove the top rib on the right side to relieve compression of the nerves,” he said.

Dr Van der Merwe in theatre, using the da Vinci surgical system.