Québec has a first in using robotic surgery for prostate cancer

Montréal 26 May 2006On May 5th, Dr. Assaad El-Hakim performed the first robotic radical prostatectomy at the Hôpital du Sacré-Coeur de Montréal. This innovative procedure for prostate cancer was a premiere in the province of Québec. Dr. El-Hakim is an urologist specialized in the minimally invasive treatment of urological cancers, including robotic and laparoscopic surgery. He is an assistant professor at McGill University, the Royal Victoria Hospital, and is also an associate member at the Hôpital du Sacré-Coeur de Montréal. He enjoys a unique expertise in Québec, since he is the first Canadian urologist with specialized training in robotic radical prostatectomy. He acquired his training in the United States where he was involved with over 150 robotic prostatectomies.

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Robotic prostatectomy is the latest and most revolutionary advancement in the surgical treatment of prostate cancer. The procedure uses a surgical robot, the DaVinci Surgical System provided by Intuitive Surgical, that is fully controlled by the surgeon. A 3D telescope and extremely fine instruments are introduced through 5 or 6 small openings in the lower abdomen. This procedure offers multiple advantages over conventional open surgery. Blood loss is decreased by 5 to 10 folds and transfusions are practically eliminated. Pain is also significantly reduced after robotic prostatectomy in addition to shorter hospital stay and overall convalescence period. In the United States and several European countries the number of robotic prostatectomies performed has been rising exponentially since the inception of this technique in 2001.

The inherent characteristics of the surgical robot confer major advantages over conventional and laparoscopic surgery. The surgeon is comfortably seated at the working console and looks through a binocular. The image is magnified by 10 to 15 folds and is displayed in three dimensions alike an Imax movie. As such, the surgeon is completely immersed in the virtual operative field. Instruments are millimetric and can move in all special configurations just like human arms due to their wrist capability. In addition the robot abolishes tremor via a tremor filter and incorporates a scale down option of 3 to 5 folds, all of which add to the technical precision.

These characteristics contribute to the added accuracy and meticulousness of robotic prostatectomy and translate into better preservation of the erectile nerves and the urinary sphincter muscle responsible of urine control. Therefore, the return of erectile function and urine control are hastened after robotic prostatectomy. It is worth mentioning also that Dr. El-Hakim performs the athermal technique of robotic prostatectomy that has been recently described by the team where he received his training. The latter consists of using no energy source around the erectile nerves, which further increases chances of return of erection afterwards.

At the present time the Hôpital du Sacré-Coeur de Montréal is the only hospital in Québec that has this particular surgical robot. This system is being used by multiple surgical specialties such as general surgery for morbid obesity, cardiac surgery, and gynaecology. Dr. El-Hakim and the hospital are proud and happy to be able to offer this service to the community.


Leslie Versweyveld

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