Robotic Surgery revolutionizes science in the treatment of Penile Cancer


Penile cancer is a rare disease that can cause changes in the color and texture of the skin that are difficult to detect, and can also cause the growth of nodules or wounds that take a long time to disappear.

Recently, the Venezuelan urologist, René Sotelo, implemented for the first time in the United States, a novel technique to treat this condition through the use of a Da Vinci. This experimental technique has revolutionized the field of medicine and has opened the doors for future discoveries.

However, before discussing this finding it is important to clarify first, what is robotic surgery and what diseases have been treated through this mechanism.

Robotic surgery is a state-of-the-art minimally invasive procedure that allows the surgeon to operate through a four-armed robot, each with miniaturized instruments that are inserted through small incisions into the cavity to be treated (thorax, abdomen, etc.) In some cases, only natural orifices, such as the mouth, are used as an access route. Thus, it is possible to perform complex surgical procedures, with a unique detail and precision, as the surgeon faithfully controls the movements of the robot in real time.

This type of surgery has greater benefits than hand surgery, since patients have been shown to recover faster, postoperative recovery is less painful, there is a lower risk of infection, there is little blood loss, fewer transfusions are needed, the scars are considerably smaller and there is less risk of complications.

In addition, this surgery allows the surgeon to have greater precision, since it eliminates any hand tremors, greater dexterity and control since the surgeon with the help of technology can perform better and more comfortable during the surgical procedure, better visualization through a Technology in High Definition (HD) and in some cases in 3D.

At present there are several surgical robots that have been used in different parts of the world to treat some types of pathologies. Among the most famous is the Da Vinci Surgical System, which is a robotic surgery team developed by the US Company Intuitive Surgical and approved in the year 2000 by the US Food and Drug Administration (FDA).

The da Vinci System – which is used for multiple surgical procedures, especially in prostatectomies  is controlled by a surgeon operating from a console and designed to facilitate complex surgery using a minimally invasive approach. This factor allows overcoming the limitations of open and laparoscopic surgery, enhancing the surgeon’s skills in terms of vision, precision and control. The da Vinci robot is not autonomous; Requires in all cases the intervention and decision-making of a professional who acts as a human operator for all actions.

The Da Vinci surgical robot is composed of an ergonomic console from which the surgeon operates sitting and is normally in the same operating room. Next to the patient is located the vision tower (consisting of controllers, video, audio and image processing) and the surgical trolley incorporating three or four interactive robotic arms controlled from the console, at the end of which are coupled the Different tools that the doctor needs to operate, such as scalpels, scissors, unipolar, etc.

The Da Vinci system is accepted by the Food and Drug Administration (FDA) for multiple surgical procedures, including: radical prostatectomy for prostate cancer, endometrial carcinoma, cancer of the cervix, colorectal cancer, mitral valvular repair, coronary bypass, surgery for morbid obesity, among many other procedures.

However, and here comes the really interesting, robotic surgery had never been applied to cure something as rare as penile cancer.

Venezuelan doctor Rene Sotelo is revolutionizing the world of science, as he performed the first operation of penile cancer, using robotic surgery in June 2016.

Sotelo explains that although penile cancer is very rare, it does exist.

«It’s hard to imagine that a cancer can appear on the penis. We must make it clear, that this pathology exists“ said Sotelo in an interview to Telemundo.

It was the first time that this technique was used in California, in The United States of America for an operation of this type. The intervention is performed through the navel and natural orifices, which facilitates the prompt recovery of the patient. The doctor says that although penile cancer is rare, Latin people have the most.

It took him about 4 hours to save his penis to his first patient who is surgically involved in the United States. The Mexican patient, Juan Nuñez recovered successfully and now Dr. Sotelo is beginning to teach American doctors to implement the technique to be able to perform it in other parts of the world.

Dr. Sotelo explains that the robot allows the doctor to perform surgery with greater precision in his movements and the possibility of restoring and preserving the patient’s anatomy. Five years ago it was imperative to extract the kidney from cancer, for example, now with this intervention only the tumor is removed, preserving the organ. In addition the new surgery allows a 3D vision and greater mobility.

For now it has only been done in the United States and has given much to talk about having revolutionized the field of medicine through robotic surgery.

His work as a pioneer and pioneer in the use of the robot to perform a minimal surgery to treat prostate cancer and other complex ills in Latin America made this urologist enter the big door to the United States.

«I am fully trained in Venezuela but I worked hard in Colombia and Mexico. My dad was Mexican and I have my medical license in Mexico and Colombia. Because of the situation in Venezuela almost two years ago, I spoke at the American Congress of Urology that I would go to those countries more frequently, but they told me why you do not come to the United States. I said I did not see that possibility, I had no residence or exams «, he said.

Something that drew attention to the Venezuelan doctor was that he created several surgical techniques that for the United States were important and did not exist in the world and that were published in the main scientific journals in urology.

Some of them were the use of the robot for complex urinary fistula surgery, and the development of new concepts of surgery through the navel and natural orifices involving minimal invasion.

His achievements made hundreds of Latin American patients visit him in Caracas, and earned him more than 21 awards from scientific and governmental organizations around the world. In addition, his passion for research and teaching has led him to teach his techniques in 19 countries and has trained more than 64 postgraduate courses in 14 countries on minimally invasive urology.

Soraya Andreina Pérez