Back to the future: Ten years of Robotics at The Wesley

28-09-2020

Marking the tenth anniversary of the Robotics program at The Wesley Hospital, in conjunction with Prostate Cancer Awareness Month, A/Prof Troy Gianduzzo, Robotic Urological Surgeon and The Wesley Medical Advisory Committee Chair, reflects on the history and growth of the innovative program.

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In August 2009, the Wesley acquired the da Vinci S Robotic System, which commenced operation in January 2010 beginning with robotic radical prostatectomy. Since that time, The Wesley’s Robotics program has grown to become the highest volume program in Australia and New Zealand. In addition, The Wesley Hospital Urology Craft Group has been internationally recognised for its innovation and clinical and academic excellence. In particular, strong interdisciplinary collaboration with our radiology and radiation and medical oncology colleagues has allowed The Wesley to establish a truly world class urology unit. This strong growth and innovative culture, has been made possible through the vision of The Wesley Hospital and UnitingCare Health Executive.

More than 6500 robotic procedures have been performed since the program’s inception. At its peak, the Robotics program averaged just less than 1,000 cases per year. Despite the expansion of robotic services throughout Australia, The Wesley Hospital remains the highest volume program in the country averaging 750 cases per year. This includes around 650 urological, 35 gynaecological, and 65 general surgical procedures annually. The overwhelming majority of these procedures are radical prostatectomies with 5,422 cases performed as at 30 June 2020 at an average of 550 cases per year. The full range of robotic urological procedures is performed at The Wesley, including robotic radical prostatectomy, robotic enucleation for benign prostatic hyperplasia, robotic cystectomy, and robotic upper tract surgery including nephrectomy, partial nephrectomy and pyeloplasty.

In 2014, The Wesley Hospital became the first hospital in Australia to acquire 2 da Vinci robotic units when it obtained its first da Vinci Xi unit in addition to its then current Si unit, which has since been upgraded to a second Xi unit.  

In November 2017, The Wesley Hospital was officially accredited as Australia’s first Centre of Excellence in Robotic Surgery by the US-based Surgical Review Corporation (SRC). SRC is an independent body that assesses surgeons and healthcare facilitates worldwide to advance surgical safety and efficacy. The rigorous accreditation process assesses both surgeon experience as well as hospital infrastructure, procedures, processes, and the organisation’s commitment to excellence. At a minimum, the SRC requires that at least 100 robotic procedures per year be performed at the institution under review and that surgeons must perform a minimum of 30 robotic procedures per year.

The Wesley easily met these criteria given the high volume of procedures performed each year by our program surgeons. The SRC accreditation is an important point of differentiation for The Wesley. Any hospital with enough capital can purchase a robot, allowing many surgeons to gain access to this technology. However, The Wesley Hospital has the institutional expertise and the robotic surgical experience in its accredited surgeons to deliver an internationally-recognised world class service.

In 2019, The Wesley, along with four other hospitals internationally, was recognised for its pioneering work in urology at the Annual European Association of Urology Congress, held in Barcelona, Spain. The EAU Annual Congress is one of the premier international urological scientific meetings and is attended by around 15,000 delegates. The Wesley was the only Australian hospital to be represented at this meeting and was showcased on EAU TV in a continuous video loop to all delegates. The success of our robotics program was centre stage along with our achievements in developing prostate MRI, prostate brachytherapy, Retzius-sparing radical prostatectomy, NanoKnife irreversible electroporation focal therapy for prostate cancer, prostatic arterial angioembolisation for the treatment of benign prostatic hyperplasia, Lutetium-177 PSMA treatment for the treatment of metastatic prostate cancer, and Ga68 PSMA scanning used in prostate cancer staging.

Robotics and urological services at The Wesley Hospital have grown exponentially over the past ten years and we are fortunate to have a close-knit group of world-class surgeons, radiologists, and radiation and medical oncologists. What defines this service is our commitment to clinical excellence, innovation and patient-centred care. These first ten years of robotic surgery are just the beginning of our commitment to continue to deliver cutting-edge, world-class patient care, for the benefit of patients and their families.

A/Prof Troy Gianduzzo MBBS, MPhil, MBA, AFRCMA, FRACS (Urol)
Robotic Urological Surgeon
Urology Craft Group Chair
Robotic Advisory Committee Co-Chair
Medical Advisory Committee Chair
National Secretary Australia and New Zealand Association of Urological Surgeons