In a first for the continent, a cardiothoracic robotic assisted surgery programme has been established at Netcare Christiaan Barnard Hospital to provide less invasive alternatives for procedures involving the chest cavity, including lung cancer and cardiac surgeries among others.

Minimally invasive and hybrid cardiovascular and thoracic surgeon Dr Johan van der Merwe is leading the programme, and recently performed the first cardiothoracic procedure using the da Vinci robotic surgical system at the Netcare hospital.

Visiting UK cardiothoracic surgeon and lung cancer specialist Dr Joel Dunning of James Cook University Hospital, in Middlesbrough in the North of England, oversaw the procedure to remove a rib in a thoracic outlet decompression surgery in a 33 year old man for the relief of pain and restricted movement in his right arm.

The patient, Etienne Nel, is a former semi professional electronic sports (esports) gamer who works in implementation of software systems for maintenance programmes and is at present completing his master’s degree in Philosophy of Applied Ethics.

Four years ago, I started to notice some pain around my shoulder, and as time went on, I began feeling discomfort and ‘pins and needles’ in my right arm and hand. Through a process of elimination, I was eventually diagnosed with thoracic outlet syndrome, and by this time it had also begun to restrict movement in my right arm.

I spend a lot of time working on the computer, and I also enjoy physical activities such as swimming, Pilates, and yoga, to name a few, but these activities were becoming increasingly difficult. I could feel I was losing strength in my right arm. It had reached the point where I realised something needed to be done. I found Dr Van der Merwe, who diagnosed the condition and discussed the options available to me.

Dr Van der Merwe explains that the nerves and blood vessels to Etienne’s right arm were being pinched between his first right rib and his collarbone, impeding sensation, motion and also drainage of blood from his arm.

Instead of cutting above his collarbone through sensitive muscles, operating with this minimally invasive technology allowed us to gently remove the top rib on the right hand side to relieve the compression of the nerves.

Etienne was ready to be discharged home the following day after the landmark procedure and says that he had already regained a good range of movement on the first postoperative day.

I could feel the punctures where the robotic system’s instruments entered my body, but the recovery is going even better than I expected. I am already able to get out of bed and use my computer.