Janet Silvera, Senior Gleaner Writer
Montego Bay's Cornwall Regional Hospital (CRH) made history on Monday when the first in a series of laparoscopic radical prostatectomies was performed at the institution.
Laparoscopic radical prostatectomy is used in surgery during the early stage of prostate cancer, which has not spread elsewhere in the body. The revolutionary surgery is conducted using an instrument the shape of a tube that is inserted through the abdominal wall to view the internal organs.
The operation was performed by Jamaican groundbreaking surgeon, Dr Roy McGregor, assisted by visiting world-renowned laparoscopic urologist, Dr Chris Eden.
"Technically, it is a very challenging procedure with a steep learning curve for both surgeon and nurses, requiring modern equipment, which is why it has not been performed in Jamaica before," McGregor told The Sunday Gleaner.
Currently, in the United States, robotic surgery is the main treatment for patients with localised 'curable' prostate cancer. However, in Europe, laparoscopic surgery has been more common than robotic for this condition.
"The two techniques are essentially the same with regards to cure rate and complication rate. The advantages of both compared to open surgery are a smaller scar, significantly less blood loss (approximately 150ml vs 800 to a litre), less post-operative pain, shorter hospital stay and quicker return to work," states McGregor.
He added that laparoscopic procedures are much less expensive than robotic procedures. He adds that the outcome i.e. cancer cure rate, incontinence and erectile function are the same for open, laparoscopic and robotic surgery. He cautions that not everyone can get laparoscopic surgery.
"We don't want to stress people who have to have open surgery."
He, however, points out that this was a big step forward for CRH and Jamaica.
Already, the urologist, who was trained at St Mary's Hospital Medical School London, England, has been removing kidney stones through a small porthole (percutaneous nephrolithotomy) rather that cutting open the patient. "We remove the tip of the rib in order to get to the stone," he said.
So far, he has done twenty five laparoscopic procedure for kidney cancer and adrenal tumors, and two procedures removing the kidney or adrenal gland using keyhole surgery. The laparoscopic adrenalectomy was the first one ever done in Jamaica, he revealed.
A recent recipient of some US$130,000 from a benevolent donor in the west, he said this money has helped to purchase surgical equipment for the urology department, and the hospital is now well equipped to do laparoscopic surgeries.
Prior to the donation, McGregor used his own private equipment to do the procedures, several of which were damaged over the last two years, he admits to The Sunday Gleaner.
Not willing to give up an opportunity to take CRH to the next level, McGregor was instrumental in getting Eden, a pioneer of laparoscopic urological surgery in the United Kingdom (UK) to come to Jamaica to assist in the four procedures that were carried out throughout the week.
Eden is renowned for performing the first laparoscopic pyeloplasty in the UK in 1994, the first laparoscopic radical prostatectomy (for prostate cancer) in the UK in 2000 and the first laparoscopic radical cystoprostatectomy in the UK in 2001. He now boasts the largest series of laparoscopic prostatectomy cases in the UK, having performed over 1,700 cases.
The University Hospital of the West Indies in St Andrew also benefited from the expert's visit to Jamaica, as an operation was also performed there last Friday.
The same afternoon, they ran a laparoscopic skills workshop for residents and consultants at the capital city hospital.