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Mark Emberton
Honorary Consultant UrologistMark Emberton is Professor of Interventional Oncology in the Division of Surgery and Interventional Science at University College London (UCL). He is also the Clinical Director of the Clinical Effectiveness Unit at the Royal College of Surgeons of England, a Consultant in Urological Oncology at the University College London Hospital, and a member of the Partners’ Council of the National Institute of Clinical Excellence (NICE).
Mark is a world-class expert in prostate cancer who lectures in premier medical institutions throughout the world, and has published more that 200 research papers in peer reviewed journals. He has interests in the design and development of clinical studies, and innovative projects aimed at improving the diagnostic and therapeutic pathways for men with prostate cancer, principally through the use of novel imaging techniques and minimally invasive therapies. Mark leads a research team of clinical innovators that combine knowhow and experience in bioengineering and nanotechnology, and regularly carries out clinical studies aimed at enhancing cancer therapies.
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Prostate cancer develops in the walnut-sized gland underneath the male bladder. It is the most common cancer, other than skin cancer and is the second leading cause of cancer-related death in men.
The disease, which often develops slowly, is different to most other cancers because small areas of cancer within the prostate are common, especially in older men and may not grow or cause any problems. This presents men diagnosed with prostate cancer with some extremely difficult choices. The statistics Prostate cancer is the second most frequently diagnosed cancer in men and the fifth most common cancer overall. One in six men will be diagnosed with the disease in their lifetime and the overwhelming majority of cases occur in wealthy countries. Each year, about 37,000 men in the UK and some 210,000 men in the US are diagnosed with prostate cancer and more than 10,000 and 28,000 respectively die each year of the disease. In the US there are over two million men living with the disease and African American men have a higher incidence of prostate cancer and double the mortality rate compared with other racial and ethnic groups. In the US about US$10 billion is spent annually on treatments for the disease. Standard treatments Traditional treatments to stop the spread of prostate cancer involve surgery and radiotherapy, which has significant side effects. Following such treatments 50% of patients experience impotence, up to 20% suffer incontinence and between one and five percent who receive radiotherapy experience pain and bleeding. |
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This has four arms which hold the operating instruments and the camera. These follow the commands of the surgeon. Supporting surgical team members assist in installing the proper instruments, prepare the 1-cm ports in the patient, as well as supervise the laparoscopic arms and tools being utilized.
Why is it better for the surgeon?
With its 3-D view, the da Vinci Surgical System aids the surgeon to more easily identify vital anatomy such as the delicate nerves and blood vessels surrounding specific anatomy
The EndoWrist® Instruments provide the surgeon with the dexterity not available using conventional laparoscopic instruments to perform a delicate and precise surgical dissection, reconstruction or removal of specific tissue.
The benefits of this minimally invasive surgery are significant to patients.
- Reduced trauma to the body
- Less blood loss and need for transfusions
- Less post-operative pain and discomfort
- Minimal need for pain killers
- Shorter hospital stay
Christopher Anderson
Consultant Surgical UrologistDirectory:
Expertise:
Mr Christopher Anderson is a consultant urological surgeon with a specialist interest in renal and prostate cancer. He is the Clinical Lead of the Robotic Surgery Unit and the Lead Cancer Clinician at St George's Hospital, London.
Mr Anderson was one of the pioneers of Robotic Surgery in the UK and holds membership at the British Association for Urological Surgeons. He completed his undergraduate work at Stellenbosch and his postgraduate training in Cape Town, South Africa, before taking up a substantive consultant post at St George’s Healthcare, London, in 1999. He undertook fellowships to Cleveland, the University of Miami and Detroit in the United States before travelling to the University of Leipzig in Germany where he learned laparoscopic radical prostatectomy due to the increasing popularity of minimally invasive surgical approaches to prostate cancer in recent years.
Mr Anderson was one of the first to adopt laparoscopic techniques in urology surgery in the UK. In 2004 he introduced laparoscopic renal cryotherapy, also the first operation of its kind in the UK. He continued to develop this technique and has the largest series with long term follow-up in the country.
He was an integral member of the team that pioneered robotic surgery in the UK, introducing the robotic surgery programme to St George’s Healthcare in July 2008, and has successfully developed the service as lead robotic surgeon.
His particular clinical interests include robotic prostatectomy, robotic partial nephrectomy, robotic pyeloplasty and laparoscopic nephrectomy. Mr Anderson is available for private consultations at The Princess Grace Hospital, London.
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Robotic surgery is an extension of laparoscopic (keyhole) surgery and offers advantages that overcome some drawbacks of laparoscopy.Most people are familiar with laparoscopy in which the surgery is performed by manipulating straight instruments while viewing the movement of the instruments inside the body on a screen. There are usually a group of small incisions (1cm or less) made on the body to allow access for the ports and instruments.
During a robotic surgical procedure, the surgeon sits in the console of the da Vinci surgical system a few feet away from the patient. While watching through the console/video monitoring system, he/she moves the handles on the console in the directions he /she wants to move the surgical instruments. The handles on the console translate the surgeon's natural hand and wrist movements into corresponding and very precise movements inside the body.
Using the da Vinci System, surgeons can operate with the look and feel of open surgery, performing complex surgical maneuvers. The surgeon has intuitive control, range of motion and fine tissue manipulation characteristic of open surgery. All of this is performed through small ports of minimally invasive surgery.
One obstacle of standard laparoscopy is the loss of three dimensional (3-D) spatial relationships since the screen has only a two dimensional view (2D), like a television. The da Vinci Surgical System uses a camera that provides the surgeon with a truly 3-D view of the surgical field. The physician looks through the vision system - like a pair of binoculars - and gets a 3-D view inside the patient's body that allows the surgeon to experience the depth of the field being operated. The system also provides magnification ten-twelve times that of the naked eye, allowing the surgeon the ability to see the operating field more clearly.
Standard Laparoscopic instruments have the feel of "chop sticks". However the DaVinci Surgical Cart uses EndoWrist® Instruments that are designed to mimic the movement of the human hands, wrists and fingers. The extensive range of motion allows precision that is not available in standard laparoscopy.
The history of Robotics
The prototype for the da Vinci® robot was designed by the United States military with the hope of allowing surgeons to operate on wounded soldiers from a safe distance. Unfortunately, this goal was abandoned because the robot was not sufficiently portable for use in this capacity. Subsequently, the technology was sold to a private company (Intuitive Surgical) who adapted it for application in an operating theatre and developed an instrument that has become the most advanced tool in a surgeon's armamentarium.
By integrating robotic technology with surgeon skill, the da Vinci® Surgical System enables surgeons to perform surgery in a manner never before experienced. It has improved and magnified the visibility and enabled considerably enhanced precision.
Why is it better for the patient?
The benefits of this minimally invasive surgery are significant to patients.
- Reduced trauma to the body
- Less blood loss and need for transfusions
- Less post-operative pain and discomfort
- Minimal need for pain killers
- Shorter hospital stay
Why is it better for the surgeon?
With its 3-D view, the da Vinci Surgical System aids the surgeon to more easily identify vital anatomy such as the delicate nerves and blood vessels surrounding specific anatomy.
The EndoWrist® Instruments provide the surgeon with the dexterity not available using conventional laparoscopic instruments to perform a delicate and precise surgical dissection, reconstruction or removal of specific tissue.
Robotic surgery is an extension of laparoscopic (keyhole) surgery and offers advantages that overcome some drawbacks of laparoscopy. Most people are familiar with laparoscopy in which the surgery is performed by manipulating straight instruments while viewing the movement of the instruments inside the body on a screen. There are usually a group of small incisions (1cm or less) made on the body to allow access for the ports and instruments.
During a robotic surgical procedure, the surgeon sits in the console of the da Vinci surgical system a few feet away from the patient. While watching through the console/video monitoring system, he/she moves the handles on the console in the directions he /she wants to move the surgical instruments. The handles on the console translate the surgeon's natural hand and wrist movements into corresponding and very precise movements inside the body.
Using the da Vinci System, surgeons can operate with the look and feel of open surgery, performing complex surgical maneuvers. The surgeon has intuitive control, range of motion and fine tissue manipulation characteristic of open surgery. All of this is performed through small ports of minimally invasive surgery.
One obstacle of standard laparoscopy is the loss of three dimensional (3-D) spatial relationships since the screen has only a two dimensional view (2D), like a television. The da Vinci Surgical System uses a camera that provides the surgeon with a truly 3-D view of the surgical field. The physician looks through the vision system - like a pair of binoculars - and gets a 3-D view inside the patient's body that allows the surgeon to experience the depth of the field being operated. The system also provides magnification ten-twelve times that of the naked eye, allowing the surgeon the ability to see the operating field more clearly.
Standard Laparoscopic instruments have the feel of "chop sticks". However the DaVinci Surgical Cart uses EndoWrist® Instruments that are designed to mimic the movement of the human hands, wrists and fingers. The extensive range of motion allows precision that is not available in standard laparoscopy.
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Prostate cancer usually doesn't produce any noticeable symptoms in its early stages, so many cases of prostate cancer aren't detected until the cancer has spread beyond the prostate. For most men, prostate cancer is first detected during a routine screening such as a prostate-specific antigen (PSA) test or a digital rectal exam (DRE).
When signs and symptoms do occur, they depend on how advanced the cancer is and how far the cancer has spread.
Less than 5 percent of cases of prostate cancer have urinary problems as the initial symptom. These problems are caused when the prostate tumour presses on the bladder or on the tube that carries urine from the bladder (urethra). However, urinary symptoms are much more commonly caused by benign prostate problems, such as an enlarged prostate (benign prostatic hyperplasia) or prostate infections.
When urinary signs and symptoms do occur, they can include:
- Trouble urinating
- Starting and stopping while urinating
- Decreased force in the stream of urine
Cancer in your prostate or the area around the prostate can cause:
- Blood in your urine
- Blood in your semen
Prostate cancer that has spread to the lymph nodes in your pelvis may cause:
- Swelling in your legs
- Discomfort in the pelvic area
Advanced prostate cancer that has spread to your bones can cause:
- Bone pain that doesn't go away
- Bone fractures
- Compression of the spine
