Robot-Assisted Surgery: 200th da Vinci Surgery Completed at BJU

Last month, the Beijing United Family Hospital (BJU) Surgery team completed its 200th surgery using the da Vinci Surgical System. In honor of that milestone, we asked BJU Chair of Urology and Surgery Dr. Zhu Gang to share his experiences with robotic-assisted surgery thus far. 

The da Vinci Surgical System is a thing of beauty. It comprises a collection of small surgical instruments, a tiny endoscopic camera, and a console that the surgeon uses to control these. “Because da Vinci provides small surgical instruments, it’s very good for work in small spaces,” Dr. Zhu explains. “The da Vinci instruments are no bigger than the tip of my little finger.” In addition to being small enough to get to places where human hands are too clunky to reach, the instruments also rotate and bend in ways that human hands cannot, opening up a whole new realm of possibilities when it comes to providing minimally invasive and innovative surgical care. Thanks to these tiny, flexible surgical instruments, it’s now possible to perform surgeries through very small incisions. Smaller incisions mean less bleeding and trauma for the patient, allowing them to recover far faster than they would with open surgery. Small instruments also make surgery on hard-to-reach areas like the tongue, as well as on small and delicate organs like the reproductive organs and the organs of the urinary system, possible. 

Specific applications for the da Vinci robotic surgery assistant include treating prostate cancer and removing tumors in the kidneys without damaging surrounding normal tissues and nerves. Whereas it used to be common practice to remove the entire kidney if there were tumors in it, it is now much easier to only remove the tumors themselves, leaving the unaffected kidney tissues intact. The benefits of this are clear: “People with two kidneys live longer,” says Dr. Zhu. “In the long run, it decreases your chance of developing chronic kidney disease, metabolic diseases like diabetes, and cardiovascular diseases,” he explains. “With precision tools, we can try to resect the malignancy as much as possible and also preserve the normal tissue as much as possible. That’s the advantage.” Dealing with tumors in the kidneys and prostate are two very common uses for the da Vinci System, but there have also been many instances where da Vinci surgery has helped a patient with a much rarer condition. Dr. Zhu recalls a case where a French patient had an obstruction in the tube that leads from the kidney to the bladder. This was due to a genetic condition that many members of her family had struggled with. She had already undergone one surgery during childhood to fix the issue only to have the problem resurface as an adult. She believed that her best option was to have her kidney removed, as this was the path that her relatives had taken. 

“She was afraid of surgery and wanted to get the kidney removed,” recalls Dr. Zhu. “I talked with her about a plastic surgery that involves reconstruction of the ureter and pelvis to get rid of the obstruction. The chance of success is over 90%. We had evidence to show her, so she went through with the surgery,” he says. The surgery went well, and the patient is now healthy and still has both of her kidneys. Earlier this year, the BJU team was able to use the da Vinci system to help another patient with a rare disease. This time, the patient had a very rare form of cancer – only the third case ever to be recorded in the world. “We had a patient with tumors on his urachus; that’s a residual tube between the belly button and the bladder. When a fetus develops, they use this tube to release urine but, after birth, the tube closes,” explains Dr. Zhu. “Urachus cancer is rare. This cancer was even more rare because the patient had two types of carcinoma: adenocarcinoma and squamous cell carcinoma. Because he had two types of cancer cells and not just one, that made it the third case in the world. He had da Vinci surgery here and recovered very well.”

Since BJU first got the da Vinci Surgical System in 2015, more and more patients have opted to get da-Vinci-assisted surgery. “When a patient comes in for surgery, we can offer treatment with open surgery or with the da Vinci system,” says Dr. Zhu. “Most patients, when we offer and explain the choice, choose da Vinci. People love new techniques. Millions of da Vinci surgeries have been done in the world, so its safety and effectiveness have been proved.” Dr. Zhu estimates that roughly 60% of the 200 surgeries performed so far using the robotic surgery assistant at BJU were performed on foreigners, hailing from a dozen or so countries. “Particularly for big surgeries, if foreign patients go back to their country, they might have to queue there and do their examinations and tests again,” says Dr. Zhu. “Here, we can do things very fast. If you want, you can get booked for a surgery tomorrow – this afternoon, even.” 

“The length of our hospital stays is also very short,” continues Dr. Zhu. “For general surgery, the average length of stay is only 3.4 days. That’s very short. In the US, the average is five days. Our examinations and tests are very reliable. BJU provides a very nice environment. Our nurses and doctors are very well-trained and our patients trust us.” All of these factors help explain why many patients opt to remain in China and get treatment at BJU when they learn they have to have surgery.In many ways, the BJU Surgery team strives to provide a high level of care, and the da Vinci Surgical System allows them to do so. “The da Vinci surgical system helps us stay, both in terms of technique and in terms of instruments, on the cutting edge,” says Dr. Zhu. 

If you need surgery, you can discuss with your doctor whether the da Vinci Surgical System could help you. To make an appointment with Dr. Zhu or any other medical professional at BJU, please call our 24hr hotline at 4008-919191.

• Love robots and want to read more about how this one works? More here. 

• Want to see the da Vinci Surgical System in action? Scan the QR code in this article to watch a broadcast of a past da Vinci surgery. 

• Interested in other forms of innovative surgery? Watch this video to learn about minimally invasive hip replacements.