Hugo Robotic Surgery and early diagnosis for the treatment of male urological cancers

Prevention for men is an issue which, despite the progress made in recent years, still raises many concerns in men and is often perceived as a “taboo topic”.

Prof. Francesco Greco is one of the main specialists in urology, working for GVM Care & Research, with several years of experience in the use of robotic surgery for all malignant and acute benign urological pathologies: in this interview he helps us understand how it can improve the approach to prevention, also in the light of recent technological advances in the surgical field.

How can patients be helped to approach the prevention of urological diseases?

To get around the taboo and resistance that still pervade the issue of prevention of male urological diseases, a change of perspective may be useful. Prof. Greco suggests starting to think in terms of male well-being in general: «a holistic vision of male health helps to convey the concept of prevention as a message that is not strictly medical but linked to the overall well-being of the person. A man should go to the urologist or andrologist for his general well-being, and this also includes the medical prevention of pathologies”.

What are the male pathologies on which it is important to prevent from an oncological point of view?

On the oncological side, the most frequent male tumors are those of the prostate and testicle; in a lower percentage, there may also be cases of penile cancer. To these are added neoplastic urological pathologies that can affect both sexes, such as tumors of the bladder, kidney and ureter. Even in these cases, early diagnosis is essential: «In 65% of cases, kidney cancer does not give symptoms and when it does, the stage is already advanced. But an early diagnosis allows access to more conservative surgical treatments, such as those offered today by robotic surgery».

Robot Hugo: how does robot-assisted surgery work?

The first cases of robotic surgery, also called robot-assisted surgery, date back to about 20 years ago: during these years, surgical robots have been progressively improved, up to the latest generation ones such as the Hugo robot, which at the beginning of November 2022 made its debut in San Pier Damiano Hospital (branch of Maria Cecilia Hospital).

The use of the Hugo robot translates into significant benefits for patients. Compared to traditional “open” surgery, robot-assisted surgery allows in particular to obtain:

  • less surgical trauma, due to the absence of significant cuts;
  • better recovery of functionality (continence, erection);
  • a faster post-operative path and shorter hospitalization times: the patient can get out of bed the first day after the operation and, in some cases, can be discharged two or three days after the operation.

Robotic surgery: how can it help the management of patients with urological diseases?

Compared to the past, today the treatment of patients with urological malignancies no longer focuses only on the removal of the tumor, but has a further objective: that of guaranteeing the patient the best post-operative quality of life.

This is very important, for example, in the case of prostate cancer: removing the prostate solves the problem from an oncological point of view, but can lead to incontinence, a situation that significantly worsens the patient’s quality of life. Today, robot-assisted removal of the prostate tumor allows greater precision and helps preserve the anatomical structures that are important for the post-operative functional recovery of urinary continence and erection.

Even in the case of kidney cancer, robotic surgery can give excellent results: thanks to early diagnosis, today it is possible to remove only the area affected by the tumor, avoiding removing the entire kidney, as was done in the past. “This approach has important consequences not only on the quality of life of the patient, who does not have to resort to dialysis, but also favors an improvement in cardiovascular indices compared to cases in which the entire diseased kidney is removed” concludes Prof. Greco.