Currently, I am performing over 200 cases per annum. With over 2,000 robotic radical prostatectomies, the results of which have been published here in the leading urology journal: European Journal of Urology. The first 1000 patients showed outstanding results in terms of continence and potency and cure rates while maximising the speed of recovery and minimally invasive nature of the da Vinci robot technique. I have developed nerve and vascular preservation techniques to maximise potency. And I have also developed a technique for lymph node dissection which maximises cure rates by removing the possibly-involved lymph nodes with more aggressive tumours. In the European Journal of urology article I drew attention to the relationship between greater experience and improved outcomes - especially in the area of potency.
I write about robotic surgery regularly, especially in ther areas of learning curves (Doumerc et al BJUI 2011) and the ability to nerve-spare even with more expansive cancer (Moore et al BJUI 2011) and the ability to improve early continence results (Beattie et al J . Robotic Surgery 2012). I presented my functional outcomes on potency and continence to the Australasian Urological Association Meeting and the New Zealand Association Meeting and also to Cornell University and to the World Symposium of Robotic Surgery. Sharing the knowledge and skills that I have acquired is important to me and I mentor many robotic surgeons throughout Australasia and South East Asia.
I have performed over 4,500 cases of open surgery - the largest series of open surgery in Australasia and the fifth-largest in the World
Focal therapy using the Nanoknife
I completed Australia’s first focal therapy trial. The trial involved 20 patients who were all treated with the NanoKnife. None of these patients suffered with any ongoing incontinence or impotence. For me this confirmed the safety and minimally invasive nature of this treatment. As far as cancer control goes, the early MRI findings are extremely encouraging. I have since performed more than 250 cases and have conducted quarterly workshops to train academic centres throughout Australia, New Zealand, Europe and Asia in the technique of focal NanoKnife ablation for selected patients with prostate cancer. A central registry containing all results nationally and internationally will be maintained to help evaluate and improve the utility of this technique.
My low-dose-rate and high-dose-rate brachytherapy cases numbers over 1,000 for each type. This is the largest brachytherapy series in Australasia.
We have over 700 patients currently on active surveillance. They are assessed annually to decide on the most appropriate treatment for their cancer. Almost 1,000 per year being counselled as to the most appropriate therapy - usually given as a 'second opinion'.