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The science fiction surgeon saving more than men's lives

It IS like a scene from Alien.

MACHINE MAN: Professor Stolzenburg and the Da Vinci Robot. The arms carry out surgery with precision human hands cannot. Picture: Stefan Straube
MACHINE MAN: Professor Stolzenburg and the Da Vinci Robot. The arms carry out surgery with precision human hands cannot. Picture: Stefan Straube

An inert human body lies on a table in a shady room surrounded by masked figures. A robot looms over the figure, silently inserting four arms into its abdomen.

Video screens show the arms with heated pincers probing, burning through bloody tissue until they find what they are looking for. Eventually one arm emerges with its prize, a severed organ the size of a small plum.

There are no alien monsters in this scene, just a life-saving robot operated by one of the world's top cancer surgeons. I have a personal interest in what I am seeing because a week earlier the body on the table was mine.

In a two-hour operation, the Da Vinci robot extracted my prostate and the killer cancer cells lurking within it.

Thanks to the advanced technology and the skill of the surgeon, I suffered negligible blood loss and post-operative pain and have made a rapid recovery.

More importantly, the delicate nerve-sparing procedure significantly reduced the risks of incontinence and impotence that are almost inevitable in conventional "open" surgery. I have every prospect of resuming a normal life.

The problem is I had to go to Germany for the operation, and pay around £10,000 in hospital fees, because there are no Da Vinci machines in Scotland. I could have gone to England, where there are dozens, but it would have cost twice as much.

At least I had the choice. In 2010 I was diagnosed with prostate cancer through a routine blood test that detected a rise in protein specific antigen (PSA), a marker for cancer.

I experienced the usual shock and angst, but as the disease was at an early stage, I was assured I had time to consider a range of treatments. However all of them, from surgery to radiation and brachytherapy (implanting radioactive seeds) carried serious risks. I may, or may not, be cured of cancer, but there would be a price to pay in permanent urinary and sexual problems.

I opted for "active surveillance" involving regular blood tests and biopsies, but four years later my urologist feared further delay could result in the cancer spreading outside the prostate, "shortening my life".

Internet searches of treatment options had already led me to the robotic marvel of Da Vinci. Developed initially for heart surgery, the American machine was first used in Stuttgart in 2001. Surgeons quickly realised its potential for treating cancers of the kidney and bladder, but it is in curing prostate cancer, the most common malignant tumour in men, that it has achieved a significant breakthrough.

When cancer is confined to the prostate, removal of the organ by Da Vinci offers a 95% chance of complete cure. The bonus is a 95-99% success rate in preserving continence, and over 90% in maintaining potency in younger men. The prospects of preserving sexual function decline with age, but are still 60-65% for over 65s.

For surgeons, the robot provides unprecedented clarity, precision and dexterity, with high-resolution 3D images magnified 10 times. The surgeon has a relaxed position seated at a console, operating the robot with joystick controls much like a video game - except this is a matter of life and death.

I had a lucky break when a colleague of my urologist mentioned robotic treatment was available at the Leipzig University Clinic, where Professor Jens-Uwe Stolzenburg was among the world's most experienced Da Vinci surgeons. A few weeks later, I checked into a private room in Professor Stolzenburg's urological department in a bright, modern hospital. The medical care I received was outstanding.

A day after my operation I was on my feet, and within a two days I was strolling outside the clinic to sit on a park bench in the sun.

A week later, the professor invited me as a journalist to observe an operation identical to my own. Flat-screen monitors show the robot pincers cutting tissue, but seeing the 3D images through the surgeon's eyepieces is like being transported to deep within the patient's body.

"A few years ago in open surgery this would have been a very bloody operation," Professor Stolzenburg says. "You would be in up to your elbows. Now the blood loss is minimal."

In Germany the robot costs €2.5 million (£2 million) , but says: "How can you put a price on improving continence and potency by even five to 10%? You should never discuss the price for this.

"It is not a question of lifestyle, it is a matter of life itself. Incontinence is a disease that is more debilitating than being in a wheelchair. You can't socialise, because you smell. If we can improve the outcome with surgical precision, we must do it, without question.

"Given the wonderful benefits, what is €2.5 million for society? We discuss this too much. It should be a standard instrument in every theatre."

I concur. Barely a month after my operation, I am reaping the wonderful benefits.

l Anyone with concerns about prostate cancer can call Prostate Cancer UK's confidential Helpline on 0800 074 8383 or visit www.prostatecanceruk.org

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