SA urologist leads robotic surgery breakthrough

When Jurie Wynand Cloete heard the words “you have cancer”, he froze.

The diagnosis, prostate cancer, in September last year left him terrified.

“I thought I was going to die,” he told the Sunday Times. His fear only deepened when doctors told him they would operate using a robot.

Last month, Cloete, 50, became one of the first six patients in the Free State to undergo robotic surgery at Universitas Academic Hospital in Bloemfontein, a medical milestone that promises faster recovery, reduced risk of complications and unprecedented surgical precision for public-sector patients.

Robotic surgery is a minimally invasive technique in which a surgeon operates from a console, controlling mechanical arms fitted with surgical instruments and a 3D high-. definition camera. The system translates the surgeon's hand and finger movements into precise, scaled-down actions through tiny incisions.

Cloete, now recovering at home, said the experience was far less daunting than he had feared. “Before the surgery, the doctors put me at ease and explained everything. I was relaxed going in. Afterwards, there was only a bit of itching. I just need six weeks to recover,” he said.

At the heart of this breakthrough was Dr Viola Morolo, one of a handful of South African urologists trained in robotic surgery.

A specialist urologist and founder-director of African Synergy Health (ASH), Morolo said the technology is transforming the surgical landscape.

“Robotic surgery gives us higher magnification and precision. In prostate cancer operations, it allows us to reduce the risk of erectile dysfunction, which can have a devastating impact on a patient’s quality of life, while still ensuring we completely remove the cancer,” she said.

The initiative, dubbed the “46664 Surgical Marathon” in honour of Nelson Mandela’s prison number, saw four surgeons perform six robotic procedures in six days, across four disciplines: urology, hepato-pancreato-biliary, colorectal, and upper gastrointestinal surgery. It was a collaboration between ASH, the University of the Free State, the Free State health department, CMR Surgical and Marcus Medical.

For Morolo, the mission goes beyond surgical innovation, it’s about tackling South Africa’s crippling surgical backlog.

“I know the pain of turning patients away because of long waiting lists. That’s why ASH was created,” she said.

According to the health department, limited numbers of skilled specialists are a key driver of delays in procedures such as orthopaedics, general surgery, urology, ophthalmology, maxillofacial surgery, cataracts, ENT and neurosurgery. In the Free State alone, hundreds of patients wait months or years for life-changing operations.

Morolo noted that while there are about 13 robotic systems in the private sector, the public sector has just three.

“Robotic systems allow us to work at angles and in spaces that are very difficult to reach with conventional surgery. They shorten theatre time from four hours to about one, and patients can be discharged in three days instead of a week, ” she said.

Dr Rebecca Fourie, head of the UFS department of surgery, said the first robotic cases tackled hepatobiliary and colorectal surgery, followed by urology.

“We selected patients who would benefit most. Robotic systems are superior to open surgery in cases where extreme precision is needed, such as prostate or rectal cancer, or where the anatomy is difficult to access,” she told the Sunday Times.

The robot’s features, zoom, angled lenses and high-definition imaging allow for less damage to surrounding tissues, less blood loss and faster recovery. Large resections can be done through small incisions, meaning shorter hospital stays.

Five surgeons and two nurses have already undergone full training, including in-person instruction in Dubai, online courses and live surgeries under an international proctor.

“When we reach sufficient case volumes, these surgeons will become local trainers, helping expand capacity in the public sector,” Fourie said.

For patients like Cloete, the results speak for themselves: “I’m just grateful. I never thought something like this could be done for someone like me who could not even afford to go to a private doctor, ” he said.