Madrid, June 17, 2019:- The latest Da Vinci Robot, model Xi, has enabled doctors at MD Anderson Madrid to perform the first robot-assisted inguinal lymphadenectomy in Spain. The procedure, consisting of the removal of the lymph nodes in the groin on both sides in patients with advanced penile cancer who must not only have the penis removed, but also the local lymph nodes, is usually carried out with open surgery. “There have been cases where an inguinal lymphadenectomy has been carried out using laparoscopic techniques but never using robot-assisted technology”, states Dr. Carlos Nuñez, head of the Surgical Urology Service at MD Anderson Madrid and head surgeon of the pioneering procedure.
“One of the main difficulties when carrying out open surgery is the wounds that form in the folds of the groin and that cause high morbidity – it is something common”, the doctor explains. “It’s a very dirty part of the body and wounds open, infection sets in…. and, on occasion, these wounds can take up to a month to heal” says Dr. Nuñez, who is very pleased to have been able to perform the surgery using the Da Vinci robot and without having to make incisions in the groin – just four small incisions of less than a centimeter in length in the thigh, and the patient can go home without any wounds to worry about.
The main advantage of Da Vinci Xi is being able to work in small spaces with the finer, lighter arms of the robot. “It gives us greater flexibility, without the arms getting in the way of each other, and that means we can do precision surgery in very small areas, which would not have been possible previously”, explains the doctor.
Furthermore, Da Vinci offers multiple advantages over laparoscopy, like the increased flexibility. “Da Vinci lets us make wrist-like movements and we can even go in from the side or from the back towards the front, something we cannot do with the more rigid laparoscopy”. We must also mention the wider field of vision the system gives surgeons. “It is not just that the definition and 3D clarity is much better, but we can use more arms than is possible with laparoscopy”, points out the specialist.
Da Vinci Robot
Da Vinci has four motorized arms connected to a console controlled by the surgical oncologist can reproduce the doctor’s movements in the operating room. Thanks to a 7-pedal system, the surgeon can change from one arm to another and simultaneously manage the camera, so that the field of work and the scope for action are much greater, even in very small spaces.
The Da Vinci robot allows the surgeon to handle the camera personally, which is not possible with laparoscopy. “With laparoscopy, the assistant handles the camera, so you operate through the eyes of the assistant, who does not always focus on exactly what you want to see”, explains Dr. Nuñez. This changes with the use of the Da Vinci system because it is the surgical oncology who calculates distances and focuses on what he/she needs at any given time.
In addition to helping in inguinal lymphadenectomies, the Da Vinci robot can help with other laparoscopic urologic surgeries, like nerve-sparing radical prostatectomy, partial nephrectomy, pelvic lymphadenectomy and so on.