10 UROLOGY, URO-ONCOLOGY AND SEXOLOGY UPDATE Profile on Dr Lance Coetzee UROLOGIST AND CHAIRMAN OF THE PROSTATE CANCER FOUNDATION With over 1300 robotic assisted laparoscopic prostatectomies behind him, Dr Lance Coetzee is one of South Africa's highest volume robotic prostate cancer surgeons. He is recognized both locally and internationally as a leader in the eld of prostate cancer. He is a Senior Consultant Urologist (Uro-oncology and Reconstructive Urology) in the Department of Urology at the University of Pretoria and has a private practice at the Urology Hospital in Pretoria. In 2007 he founded the Prostate Cancer Foundation of South Africa and has served as its chairman since its inception. We asked him some questions about his life, his career, and his passion for prostate cancer What inspired you to specialize in urology? It was due in part due to fate. During my housemanship the person who was due to take over from me was unable to, so I stayed on. I was then posted to 1 Military hospital for my military service, and when they heard that I had some urology experience they placed me in the urology department. I was originally thinking more of becoming a thoracic surgeon, but my stint in the urology department at 1 Military hospital fortunately steered me in a different direction. How difcult was it to make the transition from open surgery or laparoscopic to robotic surgery? I had done a lot of open surgery, so it was a fairly easy transition. Laparoscopic surgery is almost counterintuitive and makes the transition more difcult. If you know the operation well, it's really just about adjusting to the platform and getting over the nger troubles. For a a radical prostatectomy, robotic surgery is actually easier than open surgery. You don't have to open up the patient, you just place the ports in and you are immediately in the eld that you are going to be working in. You can also access small spaces buried behind the pubic bone that you can't see with open surgery. The instrumentation is so much more precise, and the superior vision allows for a much better nerve sparing procedure. I believe that in experienced hands, robotic surgery is better able to preserve continence and potency, and there is far less blood loss and a shorter hospital stay. In fact, we are now able to operate on older patients who would previously have been disqualied from having their prostate cancer surgically managed, because of the much more invasive nature of open surgery.
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