KUDOS FOR SA’S KEYHOLE SURGEON

DR FARZANA Cassim is South Africa’s first and only female surgeon who is competent in robotic surgery.

Cassim currently performs robotic sacrocolpopexies with hysterectomies, if needed. Robotic-assisted sacrocolpopexy is a type of surgery done to repair pelvic organ prolapse. This can happen in women who have had a hysterectomy.

Cassim, a specialist urologist, and a subspecialist in urogynaecology, based at Tygerberg Hospital and affiliated to Stellenbosch University, said it was an amazing feeling performing her first robotic surgery.

“I didn’t think that we would ever have this technology in the public health sector, so it is exciting to be able to offer our patients this option,” said the mother of one.

She said this type of surgery compared to the conventional method, allowed for better vision, and therefore a shorter operative time with less blood loss and greater precision. “Our patients are able to go home sooner as the recovery period is also shorter.”

Cassim said the purist terminology was robotic-assisted laparoscopic surgery, an extension of laparoscopic surgery or “keyhole” surgery.

“It’s a minimally-invasive approach which means that instead of making big cuts to perform the procedure, we work through small incisions (less than a centimetre each) using a camera and small instruments to act as an extension of our hands inside the patient. The magnification is 10 times normal, which allows for superb vision, and the intuitive instruments means that the instruments are literally like an

extension of your fingers,” she said.

Cassim described the training to conduct robotic surgery as a rigorous programme involving on-line training, in-person technical training, and a minimum of 30 hours spent on a simulator.

“The final step in training was done overseas where you operate on a live pig in order to ensure that you are a safe and proficient robotic surgeon prior to operating on patients. I went to Berlin in Germany, but there are various centres in Europe and the US where one can go for training. A proctor (trainer) is with you for your initial surgeries as well, allowing for a very safe transition into robotic surgery.”

Cassim said from very early on as a student she knew she needed to do something involving surgery, as theatre was her happy place.

“Urology offers a variety of patients, keeping it interesting, and meaning that we are always studying, researching and training to be better. When I say variety, I mean that we need to know about kidneys, bladders, prostates, cancers, paediatric urology, female urology, stone work, robotic surgery, as well as reconstructive urology. No two patients are ever the same,” said Cassim.

As a senior lecturer at Stellenbosch University, she is involved in training medical students, as well as doctors specialising to become urologists. She also does a lot of clinical work, involving clinics, theatre, ward rounds and on-calls, as well as research.

“I have been very blessed to be a part of this robotic programme, as well as to be awarded my subspecialty qualification in Urogynaecology. I have been an invited speaker to various congresses, both local and international. But my greatest achievement is probably raising my lovely daughter with my incredible husband, both of whom are my greatest supporters in every way,” she said.

Cassim said the medical field in South Africa was very progressive, and largely underestimated. “We have phenomenal professors, researchers and clinicians in both the state and private sectors,” she said.

Dr Kurt Maart, manager of medical services, said Cassim was the first female surgeon who was competent in robotic surgery. He said Tygerberg Hospital, as an academic or training hospital, aimed to train all their surgical trainees, including many female surgeons, in the art of robotic surgery. “Farzana is an extremely competent urologist and patient-centred health care professional," said Maart.