Robotic surgery has been around for many years. In fact, the first major milestone in the field of this kind of surgery was when the robot PUMA 200 was used for needle placement in a CT-guided brain biopsy more than 25 years ago. Since then, scientists have developed and introduced progressively more cutting edge technology, changing the face of medicine forever. 

According to South African urologist, Dr Kabo Ijane, who practices at the Urology Hospital in Pretoria and qualified as a robotic surgeon, after training both locally and in Europe, it’s imperative that more surgeons embrace robotic surgery so that it can become a mainstream practice in hospitals around the world. Ijane is also Africa’s first black robotic surgeon.

Robotic surgery has successfully been used in almost 2 000 major urological procedures at the Pretoria Urology Hospital. It became the first South African institution to acquire a robot six years ago, and was the first hospital in South Africa to perform robotic surgery, implement a robotic pharmacy picking system and now has one of only a handful of 3D laparoscopic surgical units in South Africa. 

This form of surgery is experiencing dramatic global growth due to multiple benefits and is expected to hit $24 Billion by 2025. But what is it and how does it work?

‘Robotic-assisted’ surgery

When you think of robotic surgery, the first thought that comes to mind is probably that it’s only you and a robot in the operating theatre – without any surgeon involved. But robotic surgery just refers to a scenario where human surgeons use robotic tools to operate on you.  

The robotic surgical system enters the patient through a tiny keyhole incision. The surgeon controls the arms while seated at a computer console near the operating table, which gives a high-definition, 3D view of the surgical site.

The robotic instruments are powerful and useful, but the surgeon is always in control. For this reason, it’s best to think of it as “robot-assisted” surgery. 

The benefits

The top advantage of robotic surgery is that it allows surgeons to perform complex surgical procedures using a minimally invasive approach. The robotic instruments also give surgeons a 3D view of the inside of a human body, which is a tremendous advantage over standard laparoscopic surgery where everything viewed is two-dimensional (2D). 

“Robotic surgery affords us more precision, allows us to access difficult places, and there’s the advantage of magnification and three-dimensional viewing,” said Ijane, who is one of 17 qualified robotic surgeons at the Urology Hospital.

The 3D view introduces “depth” for the surgeon, and this better visualisation extends their ability to perform a surgery more precisely and allows them to perform very technical and delicate actions.

“From a patient’s perspective, recovery is much quicker, they spend much less time in hospital (about two days compared to up to 10 days for open surgery), they’re back at work much sooner – sometimes within two weeks – and generally don’t require blood transfusions,” he added.

Without the robotic equipment, surgeons often have to make large incisions in order to reach the organs they need to operate on. This leaves the patient with big, ugly scars and long recovery times. However, with robotic surgery, because the incision is a lot smaller than with traditional surgery, it looks more cosmetically pleasing.

The instruments can also access very tight spaces that surgeons can’t reach with conventional instrumentation during open or laparoscopic surgery.

Less blood loss

Perhaps one of the greatest advantages is that there’s less blood loss. The Swedish Medical Centre states that about 30% of patients will get a blood transfusion after open surgery, but the transfusion rate is less than 1% when robotic surgery is used. If patients don’t require a blood transfusion, this means they won’t feel anaemic and will have more energy than after open surgery. 

Since qualifying, Ijane has conducted 11 prostatectomies (removal of cancerous prostate) and plans to expand to other procedures. Ijane adds that the Urology Hospital also conducts regular robotic procedures for bladder and kidney conditions and says the future of robotics may include reconstructive urinary work, pelvic floor procedures, ventral hernias and gynaecological operations such as hysterectomies and myomectomies.

“With robotic surgery the sky’s the limit. The potential to do multiple procedures is endless and is limited only by what patients and medical aids can afford,” he said.

Should all surgeries involve robots?

Because robotic surgery allows for more precise vision, instrument control and dexterity, it is ideal for many surgeries. It’s gradually replacing traditional open surgery in many fields, including prostate, pelvis, urology, cancer of the rectum and various other ailments. 

It’s critical that each patient be evaluated on an individual basis, as robotic surgery is not the best option in all cases – which means that there will still be a need for laparoscopic and open surgery in the foreseeable future.

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Compiled by Zakiyah Ebrahim

Amid the highest recorded pollen counts in history, Health24 will be bringing you exclusive pollen count updates courtesy of the UCT Lung Institute’s Allergy and Immunology Unit.

Here are the major city updates for 31 October:

Cape Town (Western Cape)

Overall levels decreased sharply this week after torrential rains and unseasonally low temperatures, with the level now just in the moderate range and a welcomed break for allergy sufferers. The post rain days saw small spikes of ascospores Low grass and weed levels were seen, with the last few pollen grains of mulberry, eucalyptus, rhus and olive been detected. 

Count: 9 (moderate) 

Johannesburg  (Gauteng)

The overall counts decreased to just into the moderate range.No grasses were seen and weed pollen was also very low. Tree pollen was low but was represented by: Ash, bush willow, mulberry, eucalyptus, olive, plane, poplar and oak. Moulds were low. 

Count: 7 (moderate)

Pretoria (Gauteng)

Tree pollen levels continue to decrease and overall levels are now just in the moderate range.A variety of trees are still detectable including: yellowwood, popular, white stinkwood, pine, plane, bush willow, rhus, mulberry, eucalyptus, ash and acacia.

Grass and weed pollen counts were low. Very few fungal spores were detected. 

Count: 9 (moderate)

Bloemfontein (Orange Free State)

Overall pollen levels stayed just inside the high range for this week. Trees counts are low to moderate with the following species identified: acacia, cypress, mulberry, eucalyptus olive, white stinkwood, and rhus.Grass pollen was low to moderate; and weed pollen was also low with daisy, goosefoot and Erica identified.Fungal spores were low. 

Count: 20 (high)

Kimberly (Northern Cape)

Low overall counts continued this week. Tree pollens identified included pine and olive.Grasses and weed pollen was low, but included English Plantain and daisy.Fungal spores were consistently low.

Count: 2 (very low)

Durban (KZN)

The east coast is the place to be if you are pollen sufferer, with low overall counts continuing. The previously high fungal spore levels also decreased substantially. A variety of tree species were identified including birch, eucalyptus and lauraceae. Weed and Grass pollen levels were low; daisy was the identifiable weed.  

Count: 2 (very low) 

Port Elizabeth (Eastern Cape)

Very low overall counts in Port Elizabeth continued this week with ongoing rain and strong wind. Tree and grass pollens were all very low, and the trees identified included: pine, mulberry and eucalyptus.A single grain of English plantain weed pollen was seen. Fungal spore levels were light.

Count: 1 (very low)

See the full report HERE.

Reference ranges:

Overall, Trees, Grasses and Weeds all use the same values (grains per cubic metres of air)

Overall count is the daily average of pollen grains per cubic metres of air (trees plus grasses plus weeds)

In partnership with the the UCT Lung Institute’s Allergy and Immunology Unit.

As the pollen problem worsens, precise and expanded monitoring becomes even more essential. And here’s how you can help.

Jillian Bell stars as a young woman who loses perspective when embarking on an extreme health kick.

Most cases of hip dysplasia are being missed at the six-week GP check, leading to problems later on.

There are calls for the government to introduce legislation on how schools should manage allergies.

The virus can cause ‘immune amnesia’ which shifts our defences back to a ‘baby-like’ state.

Motherhood means giving up a lot of me time, and even the most basic tasks are constantly interrupted by the wants and needs of kids. With this in mind, mother-of-two Katie Poirier decided to give a super relatable shout-out to other busy mamas by sharing a hilarious photo that truly depicts the struggle. 

On October 9, Poirier took to Instagram to share a photo of herself breastfeeding her newborn. But it wasn’t the typical close-up nursing shot. Instead, she showed herself trying to eat her own meal, too.

RELATED: This Mom Just Shared a Raw Photo Showing What Postpartum Depression Really Looks Like

“Well, if this isn’t post-partum in a nutshell… Actually, this is just motherhood. Welcome to eating your meals wherever you can get them,” she captioned her photo. “Just wanna give a shout out to the moms eating their meals on the go while driving kids to and from ALL the activities⁣.”

She went on to acknowledge other ways moms try to fit in a meal while taking care of kids.

RELATED: This Mom's 2 Kids Busted Into the Bathroom While She Was on the Toilet—And You Have to See Her Emotional Response

⁣“The teacher moms eating in a classroom while simultaneously helping a student,” she wrote. “The health care worker moms eating hospital peanut butter and graham crackers for yet another meal.⁣”

Poirier added that moms need to block off time to take care of themselves, even while caring for little ones. 

“As I was shoveling cold pasta down my gullet, I was reminded that everyday we prioritize the needs of others over our own,” she wrote. “That’s wonderful and just what we do as moms often without any thought. The least we can do for ourselves at the end of the day is to take a minute, look in the mirror and say ‘I’m a good mom.’ No ifs, ands or buts, just ‘I’m a good mom, period.’”

RELATED: Moms Are Leaving Encouraging Post-It Notes In an Airport Pumping Pod, And We're Feeling All the Feelings

Poirier's message resonated in a big way with her followers, who shared similar experiences. “The graham crackers and PB comment is 100% accurate,” one wrote. “It's so amazing that you can do this! I've tried to multitask while breastfeeding but can't do it,” another added.

Ultimately, Poirier wanted her followers to know that even though motherhood can be a tough time crunch, she supports all the women going through it. 

“Wherever you’re eating or not eating today, I see you and you’re doing a good job,” she wrote. 

To get more stories like this delivered to your inbox, sign up for the Real Wellness WomenIRL newsletter

Too much salt has long been linked to high blood pressure. In fact, one way to help control blood pressure is to reduce your salt intake. Research done at Vanderbilt University and published in The Journal of Clinical Investigation shows that salt may also be involved in weight gain.

Traditional thinking has been that salty foods make people drink more water, but the scientists found that it actually reduces thirst and makes people more prone to overeating, weight gain and even metabolic syndrome, which can lead to diabetes and other serious conditions.

Packaged foods with high salt content

• Smoked and cured meats, like frankfurters
• Frozen dinners
• Canned meals
• Salted nuts and seeds
• Processed cheeses
• Crackers and croutons

Since most Americans eat 50% more salt than recommended on a daily basis, it’s more important than ever to find ways to cut back. The National Kidney Foundation suggests limiting prepared foods with a high salt content.

In addition to packaged and deli meats, some canned and frozen foods, from beans to vegetables, can have very high salt levels, so always read labels. Foods you may not associate with being salty could still have sodium in the ingredients. Look for no-salt-added brands. When that’s not possible, rinse the food under cold running water to remove as much salt as possible.

When cooking and seasoning foods, replace salt – including garlic salt and onion salt – with herbs and spices. Pure granulated garlic and freeze-dried onions should be acceptable alternatives.

At restaurants, ask the chef to limit the salt in your food and reach for the pepper, not the salt shaker, if a dish needs more seasoning.

Give yourself up to eight weeks to undo a salt habit. Once you lose your taste for it, you’ll also find it a lot easier to taste when foods have too much salt in them.

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HealthDay

Asthma is a chronic disease characterised by recurrent attacks of breathlessness and wheezing, which vary in severity and frequency from person to person.

The World Health Organization (WHO) estimates that there are currently about 235 million people worldwide who suffer from asthma.

It is also the most common chronic disease among children. 

Assessing asthma control 

An asthma attack occurs when the linings of the bronchial tubes swell. This causes the airways to narrow, which reduces the airflow in and out of the lungs.

According to the WHO, the strongest risk factors for asthma are a combination of genetic predisposition with environmental exposure to particles being inhaled. 

Your asthma can be controlled with the help of medication and by avoiding triggers that irritate and inflame your airways.   

Asthma severity is assessed only at the first consultation to decide which initial treatment to start, but after this your doctor will use a guideline to assess asthma control in order to guide decisions to either maintain or adjust therapy. 

The following categories are used to indicate the severity of your asthma:

Intermittent asthma

If you have symptoms of wheezing and coughing for not more than two days a week, you are considered to have intermittent asthma.

Outside of these few episodes, you will not experience any other asthma symptoms.

Anyone with asthma symptoms that last more than two days a week or two nights per month, on average, is then no longer considered to have intermittent asthma but persistent asthma. Persistent asthma has 3 levels of severity.

Mild persistent asthma

With mild persistent asthma, symptoms occur more than twice a week but less than once a day.

Nighttime flare-ups occur more than twice a month but less than once a week. Lung function is 80% of normal or even greater.

Moderate persistent asthma

If your symptoms occur daily, your asthma is classified as moderate persistent.

Flare-ups also occur and last on average seven days.

Coughing and wheezing may disrupt your daily activities and make it difficult to sleep. Nighttime flare-ups may occur more than once a week. In moderate persistent asthma, lung function is roughly between 60% and 80% of normal and that is without treatment.

Severe persistent asthma

If your symptoms occur daily and often, you will be considered to have severe persistent asthma.

Your symptoms will frequently curtail your day to day activities and disrupt your sleep. Lung function is less than 60% of the normal level without treatment. Severe is the least common asthma level.

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Jemima Lewin

Smoking is a notoriously tough habit to quit, but a new study suggests it is far harder for women to stop than it is for men.

Why? The researchers point to a higher prevalence of anxiety and depression in women, which might interfere with even the best intentions to kick the habit. And one expert noted that prior evidence has shown that women’s brains react differently to nicotine.

No one-size-fits-all

In the latest study, involving more than 200 patients at St. Michael’s Hospital in Toronto, the prevalence of anxiety or depression was 41% in women while it was only 21% in men.

Depression and other mood disorders need to be addressed in women who smoke, especially those with heart disease and stroke, said senior study author Dr Beth Abramson, an associate professor of medicine at the University of Toronto.

“Smoking cessation is the most significant modifiable risk factor to prevent heart disease in women, but there is no one-size-fits-all,” Abramson noted.

In the study, the average age of participants was 56, and almost one-third were women. Patients reported smoking an average of 18 cigarettes daily for 37 years. Two-thirds had lipid abnormalities such as dyslipidemia, in which blood levels of lipids (triglycerides and cholesterol) hit the roof. Nearly two-thirds had high blood pressure, close to half reported heart disease, and more than a quarter had depression or anxiety.

After six months, 58 (25%) participants stopped smoking, while 68 (29%) cut back on the number of cigarettes smoked by more than half. The total number of clinic visits, use of prescription medications such as Chantix (varenicline) to treat smoking addiction, gender and the ability to afford treatment all influenced the chances of success. While using Chantix more than doubled the odds of success, women were roughly 50% less likely to quit smoking than men.

Female brain reacts differently

Tobacco smoking is the number one cause of preventable death worldwide, and accounts for 480 000 deaths annually in the United States alone. About 12% of all American women aged 18 and older smoke tobacco, according to the US Centers for Disease Control and Prevention. Programmes to stop smoking have shown varying degrees of success.

Although some studies haven’t seen a difference between men and women when it comes to quitting smoking, other studies have suggested that the female brain reacts differently to nicotine, said Patricia Folan, director at the Center for Tobacco Control at Northwell Health, in Great Neck, New York.

“Because of this difference, women may not be as successful in quitting when using nicotine-replacement products,” said Folan, though they may succeed if they take Chantix or Wellbutrin (bupropion).

Folan added that “some women have a fear of weight gain after cessation.” That’s why it’s important to counsel women that after quitting cigarettes, food may taste and smell better, and some weight gain is expected.

“Stocking up on healthy foods, particularly fruits and vegetables, and keeping hydrated with plenty of water will be helpful in avoiding weight gain,” she said. Also, women will most likely have more energy and stamina for exercise when they quit, which can help offset potential weight gain and help with stress relief.

Patient-specific counselling

Women also tend to use cigarettes to deal with stress in their lives, Folan added. So, combining drug treatment with behavioural change can help women quit smoking.

“Quit smoking apps, like the HelpMeQuit app developed by the New York City Department of Health and Mental Hygiene, are freely available and can track progress, offer support, provide distractions during cravings, and help keep individuals motivated,” Folan said.

However, women smoke and stop smoking for different reasons than men. For instance, “some women stop smoking during pregnancy,” Abramson said. So a larger study of women with patient-focused treatments and tailored therapies, including patient-specific counselling, is needed to address the different biological and social factors involved.

The findings were presented recently at the Canadian Cardiovascular Congress in Montreal. Such research is considered preliminary until published in a peer-reviewed journal.

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HealthDay