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30. January 2023
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Da Vinci Robotic Surgery Vienna

Generation Playstation instead of Generation Golf

At the Wiener Privatklinik, operations are now performed with robotic assistance. The system, which cost around two million euros, is called “DaVinci”: the surgeon no longer stands right next to the patient’s bed, but sits a little distance away and works by remote control from a kind of console. There are currently 22 “DaVinci” surgical robots throughout Austria. Among private hospitals, only the Wiener Privatklinik has this system – incidentally, the Vienna General Hospital also currently has only one “DaVinci” robot.

Wolfgang Loidl, a urologist from Linz, is a specialist in this field and has already successfully performed around 1,600 operations with it – all of them prostate operations, although the “DaVinci” robot is also suitable for other minimally invasive procedures. The doctor has a three-dimensional view of his operating field, which is brightly illuminated by diodes, in the very best 4K quality and can see even the finest structures such as nerves and vessels. The tiny interchangeable instruments at the ends of the robotic arms were specially developed for the system and can be moved in seven degrees of freedom – more than those of the human hand. Incidentally, there is also no more trembling, which means that wounds or connections can be sutured precisely and tightly. Because operations are performed with such precision, the risk of injury is also reduced: In all the operations Loidl has performed so far, not a single unit of blood has been needed. The complication rate is the lowest compared to other methods. The time to normalcy after the operation can thus be shortened considerably. Incidentally, the young, the Playstation generation, have an easier time on such robotic systems than the older ones, the “Golf generation”.

Lung cancer and prostate cancer are the most common cancers in men in Austria. With around 6,000 new cases annually, prostate cancer is in first place; it now occurs even more frequently than breast cancer among women. The causes of prostate cancer are still largely unknown – so the only thing that really helps is early detection. However, many men shy away from early detection because they are afraid of a rectal examination or even because they are afraid that they might have the disease. If it comes to a removal of the prostate gland, the loss of potency and incontinence is feared.

“We are increasingly operating on older patients,” reports Loidl, an internist. He adds that the older generation is in better health compared to the past. “Sixty is the new fifty, seventy is the new sixty…” The rate of new cases of prostate cancer among Austrian men in 2020 was in the lower third in a comparison of the 27 European countries: Austria holds 20th place.

The earlier men have themselves examined, the larger the “treatment window”, i.e. surgery does not have to be performed immediately. In any case, a urologist should be consulted from the age of 45; if there is a family history of prostate disease, the doctor should be consulted from the age of 40.

In addition to the palpation findings, the PSA value plays an important role. PSA is an enzyme that is produced by all men and only in the prostate. If the values are “only” elevated, the further development is observed: “We wait like the hunter at the high stand,” says Loidl. Only in the event of progression does the question then arise as to whether surgery or radiation should be performed. Among the two methods, none can be preferred over the other; this must be decided individually and is not comparable, Loidl states.

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