I have been thinking how to thank you after such an intense and successful surgical procedure, and I decided to do it with this mail. Recounting my experience in some detail.
Where it all began
Two and a half months ago I suddenly noticed a prolapse that stunned me, and made me seek medical help and a diagnosis the next day. I was seen by a radiologist and a gynae on the same day. The gynae then referred me to you as a surgeon, and you performed several examinations to determine the extent of the prolapse. I was also sent for a CT scan at radiology.
The decision was then made that I needed to have a repair done asap, because any further abdominal pressure, or pressing down or lifting of things could only worsen the problem. It could also become a dire situation if my small intestine got twisted or strangulated into the whole problem area. I was informed of the Da Vinci procedure as an option, which was a robotic laparoscopic intervention which had specific benefits above a normal laparoscopic operation, and major benefits over open surgery. I was very interested in having this procedure, mainly because you told me about the short recovery time, perhaps being discharged the next day already. This sounded very appealing to me and was eventually exactly how it played out, to my satisfaction.
Deciding about the Da Vinci procedure
The Da Vinci procedure was booked for Saturday morning, the 2nd of September 2017, and even while my medical aid / hospital plan rejected authorisation of this procedure, I felt I had no choice but to proceed with it. The finances would have to be addressed later. I received valuable physio treatment for a few weeks by then already, from Marietjie Martin who is part of the team, but an operation was clearly still necessary. There was no doubt in my mind about that. I had also been told that the injury could get worse. To my understanding the improved control which a robot could offer seemed comforting, because of the delicate nature of the operation. The timing of the operation was also critical to me. I could not wait a month or two, or until year end, since I am one of a small team of professional cath lab radiographers at Panorama Mediclinic, and we had already planned all staff absences until yearend (congresses, leaves etc). Each of us has key responsibilities to fulfil and I could simply not stay off work.
Making it to the theatre
I hardly rested before the operation due to being pre-booked for the ESC2017 Heart Congress in Barcelona, Spain. I only returned late the Friday afternoon the 1st of September, and had to report to the hospital 12 hours later. I promptly drank my preparatory medicines, and finally went to bed 12.30am on the morning of the operation. I got up 4am and went to the hospital. I was in theatre by 7am, and I believe I was back in my ward roughly by 10.30 or 11am. Still somewhat sedated.
After my operation till the next morning in hospital
I felt well after I woke up. The first day I mainly had soups to eat (for lunch and supper) and I noticed I was not aware of any pain. This became a hallmark of the whole ordeal. Right until today – almost three weeks later - I never experienced any pain. Right after the operation I was very glad that I did not have a catheter in, and that I could go to the toilet by myself. The drip was merely disconnected and reconnected by my nurse. My discharge was authorised by Dr Rademan the next morning at 7h00, about 20 hours after surgery was completed. I was told that I could drive, go to the gym to do treadmill and steps, and as soon as I felt well enough, I could start working! My work entails long hours of standing, and I obviously had to be careful not to wear my lead apron initially, or to push hospital beds or to push the hanging tv monitors in the cath lab and so on. Good news to me!
I have also resumed the pelvic muscle control exercises by now. This was taught to me by the physio a few weeks prior to the operation already.
The next two days after the operation
I was told I could have “normal food” after getting discharged, and by the morning after my operation I was quite ravenous. I felt comfortable to go to an early Sunday lunch after my discharge and I took it easy for the rest of the day, with an afternoon nap included. I had very little rest until then and the Saturday night after the operation was not quite enough yet to get fully rested. I was only scheduled to work the Tuesday, so on the Monday morning I took my daughter for brunch and when I returned home I again took it easy for the rest of the day, taking another afternoon nap.
I can mention that urination went fine from the first day, and bowel movement only resumed some time later since I had an empty stomach after the operation. To prevent pressing down too hard I have been using Movicol until my follow up visit with the surgeon, after which I will be phasing it out.
The 3rd day after my operation
By Tuesday morning 8am - exactly three days from when my surgery started - I reported back at work. I felt so good and I could drive already. I did my full list of patients with no problem at all. I mostly walk and stand at work. I never sit down. I must confess I really enjoyed getting to bed after the first day of work on Tuesday. By this time my body longed for a good night’s rest. From that day on I worked my normal slates at the theatre and did call duty the first weekend after my surgery, and was called out 7 times during that weekend. I have since then been working in full capacity with a mobile lead apron attached to the patient’s bed to shield me from radiation. I did not experience even one day of discomfort or pain at all. If I did not have plasters covering the incisions on my belly, I would not have believed that I had such an involved surgery done by a robot. It’s really amazing!
All in all
I can recommend this type of surgery to anyone who has a similar condition, and who need to be back at work as soon as possible. I am so grateful to you Dr Rademan, and to any assistants at the surgery, for doing such a fantastic job. It is now 19 days after the operation, my plasters are off, and although the skin is a little itchy I feel so relieved to be rid of my problem and to be able to continue my life as it was before, having only really “lost” a few days. I have resumed gentle gym exercises with my personal trainer who has cleared all exercises with my physio, and I could also resume normal activities. This is just first class. I feel like running and jumping and dancing with joy. There was not even one day that I can say I did not feel well, or mentally down. And all this…thanks to you…you have done fabulous repair surgery to me. Thank you, thank you!
I also want to thank Mediclinic Durbanville for giving me the opportunity to have the surgery done. A very gracious gesture from the management. The staff were fantastic and were at my bedside every hour to check my blood pressure which was a bit low, but I felt fine because I am used to low blood pressure. I have always had a low blood pressure.
Will you also thank the theatre staff and dr Coetzee for me, for their part in making this a vast experience and success for me.
I feel indebted to you
Thanking you sincerely
Herewith feedback of my experience of the recent colon operation I had, using the Da Vinci Robot.
Background: During a routine colonoscopy examination, done by Dr E Swanepoel, he discovered that I had a polyp low down in my colon. The biopsy taken showed that the polyp was benign. After my discussion with Dr Swanepoel and on his recommendation, a transanal endoscopic mucosal resection was performed and further pathology tests done. The sessile growth showed that it contained Stage 1 cancer. In consultation with Dr Swanepoel and Dr Rademan, a decision was made to do a laparoscopic total mesorectal excision.
All the different procedural options were explained to me, in depth, by both Drs Swanepoel and Rademan. I was very fortunate that the Da Vinci Surgical robot was available to do this operation instead of the “open surgery”. The Da Vinci method involves greater precision, visualisation and enhanced dexterity for the surgeon and Dr Rademan was very confidant that he could perform this operation successfully. I made it very clear that I was not ready for a stoma and Dr Rademan agreed to respect my decision and make every effort to avoid this.
As the recovery time is extremely short with this method and I have my own business to run, it was a no-brainer to have the operation done by the Da Vinci method.
I applied for hospital authorisation from my medical aid, Discovery Health, but they declined authorisation. The full procedure was paid for by the Durbanville Medi Clinic.
The operation was done on the 1st September 2017. I was admitted to Durbanville Medi-Clinic and the operation proceeded at 11:00 am. I was out of theatre by 6:45 pm. I cannot remember much about that evening but by the next morning, Dr Rademan and his team visited me at my bedside and informed me that the operation was a great success. I was also thrilled to discover that I did not even have a temporary stoma. The catheter was removed and by 10:30 am, the day after the operation, I was walking the Durbanville Medi Clinic’s passages. I was discharged the following day, just 2 days after the procedure, to continue my recovery at home.
The recovery process from the actual operation was very quick. I felt some abdominal bruising and had 6 small incisions in my abdomen but had no pain whatsoever. There was also no post-op bleeding. Were it not for the fact that I had to get my bowel routine management under control, I can honestly say that I was ready to go back to work by Monday 11 September 2017.
A few days later the pathology report confirmed that I am cancer free! I was also later told by Dr Rademan that there would be no need for chemo or radiation treatment.
Once again a BIG THANK YOU to Dr FJ Rademan and his Da Vinci team as well as the Durbanville Medi Clinic.
I wish you all the best and continued successful surgeries, using the Da Vinici surgical procedure, which is definitely in the best interest of the patient.
-Ben van der Touw