Prof. Van der Poel mainly treats prostate cancer, the most common cancer in men. “Image-guided surgery has several advantages for the patient. We can prevent damage and reduce the risk of complications such as urinary incontinence or erectile dysfunction.”
Operating with advanced imaging
During image-guided surgery, radioactive and fluorescent dyes called tracers are used to clearly identify and localize tumors using a special camera. The high sensitivity and precision of the tracers also makes it easy to see any possible small metastases. During the operation, the surgeon sees on a screen whether enough tissue has been removed. Radio- and fluorescence-guided surgery is also useful for identifying and accurately removing lymph node metastases.
Robotic surgery
Prof. Van der Poel works at the Antoni van Leeuwenhoek hospital (AvL) where he performs robot-assisted surgeries. The robot brings many benefits, such as less blood loss and a shorter hospital stay for the patient. “Despite the name, it is not a real robot because the robot does not operate by itself. It is controlled by the movements of the surgeon.” The surgeon sits in a surgical console and, guided by steady real-time camera streams, manipulates the robotic arms using a kind of joystick. “The technical development of the cameras and dyes is expensive. A lot of clinical research was needed before we could use it with patients in the clinic.”
Prostate Cancer Network
Prof. Van der Poel is a driving force behind collaborations with other hospitals. He co-founded the Prostate Cancer Network four years ago which currently includes 12 hospitals in the Amsterdam region. This network organizes the care of prostate cancer patients regionally: prostate cancer patients from all over North Holland receive their surgery at AvL, while the rest of the treatment is done close to home in their own regional hospital. The hospitals make mutual agreements about how they will diagnose, treat, and counsel patients with prostate cancer, a process called a ‘care pathway’.
Quality Cycles
“It is difficult to conduct research without collaborations between hospitals, and this collaboration is also necessary for continuous improvements of care in the clinic. The Prostate Cancer Network enabled us to set up a quality cycle.” Within the network, Prof. Van der Poel focuses on the quality cycle. “Every month, we focus on a specific part of the operation with the surgeons. We discuss the operation and we watch parts of it on video. We also use the outcome of the operation to see how we can make step-wise improvements to the procedure every month. Six months to a year later, we check to what extent the adjusted part of the operation is contributing to better outcome. We think there is still a lot to gain, and all hospitals in the network are highly motivated to achieve better results. And, having this network means we can make adjustments based on more patients and this helps us improve the process faster.
Adapted from: “Tumor te lijf met kleurstoffen, camerabeelden en robot ” by Charlotte Nuijten
Photo: Antoni van Leeuwenhoek