Robotic Surgery at VAMED

When installation of the surgical robot was started in 2007, it was an ambitious project. All over Europe, there were only five private facilities with this technology – and Mostiště in the Czech Republic then became the sixth. The medical director of the surgical department and head of the Center for Robotic Surgery of the VAMED Mediterra Hospital Mostiště, Dr. med. Jaroslav Tvarůžek, recalls: “The goal was to further expand the minimally invasive laparoscopic procedures and make them more effective.”

Today, the VAMED Mediterra hospital Mostiště is among the top European centers that offer specialized procedures using robotic surgery for their patients. A whole host of procedures, including radical resection of the prostate, are carried out using minimally invasive techniques.

Hospital Mostiště, a center for robotic surgery

https://www.youtube.com/watch?v=tFbell4LFZg

High precision with low stress for the patient

Dr. Tvarůžek: “From the beginning, we focused on the surgery of prostate cancer. Next, we expanded the surgical program with removal of malignant tumors of the rectum and of tumors of the kidneys and the stomach.”

Robotic surgery is performed in Mostiště most frequently for oncological-surgical treatments. Its goal is to efficiently remove the tumor with as little stress for the patients as possible. “The surgical heads of the robotic instruments are very small – only 8 mm –, and they have an operational joint that allows precision of movement in the operating area to be increased”, as Dr. Tvarůžek explains.

Minimally invasive

The concept underlying robotic surgery is straightforward: The more accurately an operation is performed, and the less the surrounding tissue is affected, the swifter the patient will recover. The surgical robot controlled by the surgeon helps to achieve such precision during surgery. The robot does not operate “on its own”.

Surgeries performed using robots are minimally invasive and therefore gentle. In general, patients lose blood neither during the procedure nor in the period afterwards. They have small scars (about 5 scars with a size of about 1 cm), which usually heal very quickly and without complications. Pain also occurs less frequently. This gentle surgical procedure also shortens the duration of the entire recovery phase, so the patient returns to everyday life earlier than after classical abdominal surgery or laparoscopy.

The success of a robot program depends on which interventions it is used for. A robot is not suitable for surgical tasks that can be handled by normal laparoscopy, but is to be used specifically where it actually provides primarily clinical benefits for patients and surgeons.

One example is robot-assisted radical prostatectomy, which is a standard procedure in Mostiště. Here, the instruments can be applied to positions for which a human hand would be too large.

More than 350 such prostate procedures for malignant carcinomata are carried out at the VAMED Mediterra Hospital in Mostiště in 2017. The patients for this come from all over Europe. In order to make the patients’ stay as comfortable as possible, VAMED Mediterra has set up a concierge service, which upon request takes care of all the patients’ needs. For example, the patients can ask to be picked up at the airport in Vienna or Prague and taken directly to the hospital.

“Another proof of the high quality”, says Dr. Tvarůžek, “is the fact that the team of the robotic workplace has remained virtually unchanged over the entire decade. More than 3,000 interventions since the introduction of robotic surgery demonstrate our great experience. The data about the DaVinci surgeries and the related quality of results are regularly published in specialist journals and at congresses.”

DATA & FACTS

• Since 2007, the DaVinci system has been used for surgery in Mostiště. The second generation has now been in operation since 2015.
• The scope of robotic surgery ranges from radical prostatectomy through partial renal resection and renal pelvic plasty to rectal resection. In the future, cystectomy (removal of the urinary bladder) will also be included into robotic surgery.
• Currently, the DaVinci robot is used for about 350 prostate procedures a year, plus 30 to 40 laparoscopic gastric bypasses.
• The center also enjoys international recognition and offers a medical concierge service to assist patients in all aspects before and during their stay. Patients come from Russia, Ukraine, Spain, Germany, Slovakia, and other countries.
• Foreign patients are first counseled in detail in a Skype or telephone conversation and informed in detail by experts. Almost all patients travel by airplane to Vienna or Prague, where they are picked up by a concierge from the airport and taken to Mostiště hospital. The surgery takes place already on the next day.
• Most patients leave the hospital again after only 5 to 7 days.

Link for more Information: 10 years of robotic surgery in the VAMED Mediterra Group in the Czech Republic