Surgery with the robot in urology

Since the beginnings of robotic surgery in Switzerland, we have taken a leading role throughout Europe and have continuously improved our knowledge and skills ever since. Patients benefit in many ways: the procedures limit blood loss, result in less pain, and allow for faster wound healing. In urology, mainly prostate cancer, bladder cancer and kidney cancer are treated with the surgical robot.

How does the surgical robot work?

The Da Vinci robotic system is not an autonomous or pre-programmed robot, but a telemanipulator – a robot-assisted surgical system in which the surgeon uses joysticks to control a camera and up to three 5 to 8 mm diameter working instruments from the console. The camera transmits a three-dimensional image and magnifies the structures in the surgical field up to ten times.

The robot translates the surgeon’s hand movements into instrument movements in the surgical field. The natural trembling of the hand is filtered out in the process and the range of motion of the instruments is clearly superior to that of a human hand. “We perform robot-assisted surgery with more pinpoint accuracy than my hand ever could” says Prof. Daniel Eberli, an experienced Da Vinci surgeon.

What are the advantages of the robot for the patient?

  • Minimally invasive, only small external incisions
  • Faster recovery
  • Fewer complications
  • Gentle on nerves; decreases likelihood of complications such as erectile dysfunction and incontinence
  • Less blood loss
  • faster wound healing

What advantages does the DaVinci Surgical System offer the surgeon?

A surgical robot can be controlled via two consoles. There is a doctor at each console, with only one doctor actively operating while the other monitors. Complex operations lasting hours can thus be performed in a sitting position, which relieves the strain on the surgeon. This also makes it possible to switch between operators without any problems.

The surgeon looks at the organ to be operated on via a high-precision camera that transmits pin-sharp images in 3D optics. As if through a magnifying glass, structures that are otherwise difficult to see, such as nerve tracts, can be identified. In prostatectomy, the removal of the prostate gland, for example, it is much easier to operate in a way that protects the nerves. The likelihood of suffering from erectile dysfunction and incontinence after surgery can be reduced.

The various instruments of the surgical robots are highly precise and delicate. There is an instrument for every purpose – forceps to hold tissue, scissors and scalpels to cut tissue. These can be rotated in all directions with the smallest of movements and thus reach even hard-to-reach regions. Jerky movements are automatically corrected by the robot software, therefore unforeseen injuries are hardly possible.

Hand of surgeon with Da Vinci

Filigree instruments on the robotic arm enable high-precision surgery

When is DaVinci technology used in urology?

Initially, robotic surgery in urology was used almost exclusively for laparoscopic radical removal of the prostate for prostate cancer. This is still the most common robot-assisted procedure we perform. To date, over 2000 prostatectomies have been performed at the USZ using the DaVinci robot.

However, this modern technology is now being successfully applied in more and more areas.

Surgeries which are nowadays robot-assisted in urology are:

  • Radical prostate removal
  • Organ-preserving kidney tumor removal
  • Kidney removal
  • Renal pelvic plastic surgery
  • Adrenalectomy
  • Radical bladder removal
  • Lymph node removal in the pelvis or retroperitoneum
  • Ureteral reimplantation
  • Complex kidney or ureteral stone removal
Da Vinci Robot Doctor

The Da Vinci operator can control the robot from the console with high concentration. Hourly position operations can thus be performed in a sitting position. The image from the robotic camera is greatly magnified and transmitted to the console and several monitors in the operating room.

Responsible doctors

Daniel Eberli, Prof. Dr. Dr. med.

Director of Department, Department of Urology

Tel. +41 44 255 54 01
Specialties: Prostate cancer: 3D prostate biopsies (MRI fusion, stereotactic), DaVinci robotics and laparoscopy, HIFU (High Intensity Focused Ultrasound), Robotic surgery (kidney and bladder), Treatment of benign prostate enlargement

Daniel Schmid, PD Dr. med.

Senior Attending Physician, Vice Director of Department, Department of Urology

Tel. +41 44 255 54 40
Specialties: Urological oncosurgery (specifically prostate, bladder and kidney), Laparoscopic robot-assisted urological operations, Reconstructive urology (urethra, urinary diversions, pouch)

Ashkan Mortezavi, PD Dr. med.

Senior Attending Physician, Department of Urology

Tel. +41 44 255 54 40

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University Hospital Zurich
Department of Urology
Frauenklinikstrasse 10
8091 Zurich

Tel. +41 44 255 54 40
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Responsible Department