From shorter hospital stay to minimal pain, SJMC’s urologist breaks down the advantages of robotics surgery

KUALA LUMPUR, November 29 — Surgeries are complex medical procedures that require precision and focus.

Especially for surgeries relating to the urinary tract which includes kidneys, ureters, bladder, and the urethra which require more care and caution as any damages to surrounding nerves could result in complications post-surgery.

Patients with urological diseases that require surgery such as kidney tumour removal or prostatectomy (prostate cancer removal), commonly opt for laparoscopic or open surgeries, which can be carried out by most surgeons.

With the advancement of medical technology however, patients these days can also opt for robotic assisted surgery, which greatly improves the surgical outcome while minimising risks.

Patients will find their recovery is much faster due to smaller incisions, and they can return to their daily activities easily.

Subang Jaya Medical Centre’s (SJMC) urologist Dr. Bala Sundaram Mariappan who has been a urologist for more than 20 years, told Malay Mail that the introduction of robotic assisted surgery like the da Vinci Xi surgical system has resulted in a positive impact in his line of work.

Dr.Bala has been a urologist for more than 20 years now and is one of the pioneers of robotic assisted surgery in Malaysia. — Picture by Raymond Manuel.

“I personally think that the future of surgeries, especially for complex ones like radical prostatectomy, robotic assisted surgery is the way to go.

“Robotic assisted surgery takes every good aspect of laparoscopic surgeries and throws away the bad aspects.

“It helps with vision enhancement as it provides a 3D vision compared to the 2D vision of conventional laparoscopic surgery,” he said.

“It can also magnify the vision up to 10 times, making it clearer and more detailed.

“With the vast range of movements available with the new Xi system, surgeons will have complete control of every small movement during the surgery, and this helps when it comes to removing complex tumours more effectively.”

Dr. Bala added that working with robotic assistance feels like performing a surgery with an extra pair of hands.

For patients, robotic assisted surgery results in smaller incisions thus minimising blood loss and tissue damage, which leads to faster recovery time and shorter hospital stay.

Patients who undergo robotic assisted surgery need a few days of recovery compared to conventional open surgery method, which may take up to two weeks for recovery.

Dr. Bala pointed out that robotic surgeries are ideal for urological related surgeries and nerve sparing surgeries because of its precision.

“For example, patients with prostate cancer would need to remove their prostate and the prostate is covered by a lot of nerves. These nerves are important for other functions such as erection and so on.

“So, preserving and not damaging these nerves is very important. The risk of erectile dysfunction for patients undergoing open prostatectomy is there, but with robotic assistance, it minimises those risks.”

Considered a pioneer, he was first introduced to the Da Vinci Surgical System back in 2003 when he was serving at the Sultanah Aminah Hospital in Johor Bahru, with the only other public hospitals in Malaysia to have implemented the technology being Hospital Kuala Lumpur.

Dr. Bala has since reintroduced robotic assisted surgeries as part of the treatment options when patients come to see him.

“SJMC’s adoption of the latest medical technology like this will benefit our patients because we know how important it is for patients like men to require less downtime post-surgery and get back on their feet faster.”

Dr.Bala also shared that with robotic surgery, surgeons can now remove a kidney tumour more precisely, sparing the rest of the kidney. — Picture by Raymond Manuel.

Sharing his patients' experience with the technology, Dr. Bala said it was easier to convince patients to go for this form of surgery once he explained its benefits.

He shared that it gave one of his patients who had to undergo prostatectomy a confidence boost.

“The outcome was much better because we managed to completely remove the cancer.

“The patient himself hardly felt any pain after the surgery because of the small incision and he recovered quickly. It was very rewarding to him and us as doctors.”

For international patients, especially those from Indonesia, robotic assisted surgery can be completed in one day and the patient can start walking the next day.

“The patient even went out with his family after that and flew home the same week.”

As with any other diseases, prevention is better than a cure.

This is why Dr. Bala highly recommends that men who are above the age of 50 go for regular health screenings and screen for prostate cancer.

An unusually high prostate-specific antigen (PSA) level will indicate the need for an individual to seek further consultation with a urologist.

Prostate cancer is the third most common cancer in Malaysia which affects men as they grow older. However, symptoms of prostate cancer can be easily missed and most individuals present themselves at an advanced stage of cancer.