Haluk Akpınar, MD

Professor of Urology

Surgical robotics combines minimally invasive techniques with highly advanced clinical technology, resulting in a couple of advantages listed below. 

Urooncologic Surgery

Laparoscopy and Minimally Invasive Surgery

Endourology-Urinary stone treatment (URS and PCNL)

Robotic Radical Prostatectomy
Only in Four Questions

Robotic radical prostatectomy is a type of minimally invasive surgery which uses a surgical robot to remove the entire cancerous prostate. The robotic laparoscopic technique allows surgeons to operate through small ports rather than large incisions. The robotic vision system delivers 3D high-definition views, giving the surgeon a crystal-clear view of the surgical area that is magnified 10 times to what the human eye sees. Tiny instruments are used that move like a human hand but with a far greater range of motion. The system’s built-in tremor-filtration technology helps the surgeon move each instrument with smooth precision.

Surgical robotics combines minimally invasive techniques with highly advanced clinical technology, resulting in a couple of advantages listed below. 

  • Earlier return to sexual life: MORE The degree of sexual function after radical prostatectomy is determined by many factors. These include the patient’s age, how sexually active he was before the procedure, how much the surgical procedure affects the nerves and how sexually motivated he is after surgery. Most men experience at least temporary erectile problems after radical prostatectomy. Robotic surgery enables to spare erection nerves alongside the prostate. Patients experience faster return of erectile function than patients who had open. 1-5
  • Better urinary control: MORE After radical prostatectomy majority of the patients leak urine however this is transient and gradually urine control is gained again. Patients experience usually faster, return of urinary continence than patients who had open within 3 months of surgery. In our robotic series, 89 % of patients have satisfactory bladder control and not using protective pads 3 months after robotic surgery. Known risks for post-prostatectomy prolonged incontinence are advanced age, diabetes, non-nerve sparing surgery. Better visualization, less blood loss, and the ability to leave longer urethral length with nonleaking good anastomosis are the reasons for earlier urinary control. 1-5 
  • Fewer hospital stays and hospital readmission: MORE Patients may stay in the hospital for a shorter amount of time than patients who had open surgery. In our experience, the length of hospitalization is often shortened to 2 days. Also, when compared to patients who had open surgery, patients undergoing surgery with a robot may have less chance of being readmitted to the hospital after leaving. 14-21
  • Fewer complications, blood loss, and transfusion MORE The three-dimensional vision system magnifies the surgical field up to 10 times and improves the ability of the surgeon to recognize and control small blood vessels, thereby reducing blood loss. Almost none of the patients in our group required blood transfer. Patients may experience similar or fewer complications after surgery compared to patients who had open surgery. 6-21

Professor Haluk AKPINAR had access to daVinci Robot since 2005 and performed more then 400 robotic radical prostatectomy operations up to today. For more detailed information Haluk Akpınar, MD

Operations are done in top quality hospitals in Istanbul with XI daVinci robot by Professor Haluk Akpınar. The cost of robotic surgery is a package for a treatment of prostate cancer. Package includes:

  • operating and recovery room charges
  • surgical team fees (surgeon, anaesthesiologist, scrub and circulating nurses)
  • all medical supplies for robotic surgery
  • 3 night’s stay in surgical ward
  • routine medications used during the procedure and stay

Kidney Cancer in 8 Questions?

  • 214.000 new kidney cancer /year
  • 8th most common cancer in the World
  • Detected more in men
  • Common in fifty and seventies
  • In the last 30 years, the frequency increased 3% or more every year
  • The most important reason is cigarette and tobacco use
  • In fact, 33% of all cancers are related to cigarette and tobacco use
  • According to Turkey’s 2011 statistics, 42% of men and 13% of women are smokers
  • Due to frequent use of radiologic investigations like tomography and ultrasound.
  • Also, this can be attributed to the detection of many tumours in the early stages.
  • 2/3 of all kidney tumours are small, inside the kidney, and detected incidentally.
  • Primary treatment is surgery.
  • With early diagnosis and surgery, most patients can be cured
  • If the kidney cancer is treated in the early stages, 10 years survival rate is 79% to 100%. 
  • Surgery of kidney cancer is based on the removal of only the cancerous segment or the entire kidney.
  • Decision of surgery type is made according to size and the location of the tumour. 
  • Not necessarily, before 1990s removal of the entire kidney (radical nephrectomy) was standard procedure.
  • Now if it is possible, we do remove only the tumour with surrounding safety margin and keep the healthy part of the kidney intact (partial nephrectomy-nephron sparing surgery).
  • In my daily practice if the tumour is 7cm or smaller and in anatomically resectable position I suggest primarily robotic partial nephrectomy. 
  • If tumour is larger than 7 cm and mostly central, then I offer laparoscopic radical nephrectomy.
  • Of course, there is always special conditions that I have to tailor my approach, after discussing my patient.
  • The selection between open, laparoscopic, and robotic partial nephrectomy methods depends on the experience of the surgeon, the patient’s request, and financial condition.
  • As I said previously, I almost always suggest robotic partial nephrectomy if it is safely resectable in my hands. If it is beyond my resectability criteria than I offer laparoscopic radical nephrectomy to remove all the kidney with it is safety layers.

Robotic Partial Nephrectomy is a new standard for treatment of kidney tumors

  • Partial nephrectomy (PN) is the surgical removal of a portion of a kidney normally to treat cancer while preserving as much healthy kidney tissue as possible.
  • This operation is also known as “kidney-sparing surgery” or “nephron sparing surgery”. 
  • Partial nephrectomy can be done by open, laparoscopic or robotic methods.
  • Since it has been first done was in the US in 20031, robotic partial nephrectomy has gained widespread acceptance worldwide with several technical advantages over traditional open and laparoscopy.
  • Robotic partial nephrectomy is progressively preferred as a minimally invasive option for kidney-sparing surgery even for more complex renal tumours. 
  • While only 20% f partial nephrectomy operations were performed with robot in 2005 in the US, today, the rate has increased to 80%.

Why kidney tumor surgery with the robot?

  • Why kidney tumor surgery with the robot?

    A review of published studies suggests that potential benefits of a partial nephrectomy with robot technology include:

    • Patients experience fewer overall complications than patients who had open2,3 or laparoscopic4,5 surgery
    • Patients stay in the hospital for a shorter period than patients who had open surgery2,3,6,7,8 or shorter2,8,9,10,11 time than patients who had laparoscopic surgery.
    • Patients experience less pain than patients who had open surgery.3,12,13

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