Casey Hospital marks 100th robot-assisted surgery

Colorectal surgery is the next specialty to come on board, with Associate Professor Paul Cashin, Service Medical Director of Integrated Surgery, coordinating the rollout.

‘Associate Professor Paul Cashin is coordinating robotic services and is splitting his units so that robotic cases go to Casey Hospital, while non-robotic work stays at Dandenong Hospital,’ Dr Donnellan said.

Building a ‘pelvic service’

The ambition is to build Casey Hospital into a robot-assisted pelvic surgery hub.

‘The vision is to develop an entire robotic pelvic service at Casey Hospital. Urology will continue to expand, particularly the surgical procedure to remove the prostate gland, prostatectomy, using robotics, which already makes up the majority of cases on the robot,’ said Dr Donnellan.

The program has operated under a strict governance protocol set by the hospital administration since it began. The results have exceeded expectations.

‘It’s been more successful than we thought it would be. Cancer surgical rates and complication rates have been extremely good,’ he said.

Urology is also now offering the surgery to remove tumours while preserving the kidney, partial nephrectomies, robotically.

‘That’s a case that was previously done via open surgery, or patients had to go to Peter MacCallum Cancer Centre. Now it’s done in-house, robotically.’

The unit is also preparing to perform its first robot-assisted case for a complex bladder and prostate removal procedure, cystoprostatectomy.

‘That will bring us in line with European centres and some Australian centres. It’s a huge deal in terms of potentially reducing morbidity from that operation.’

The number of urological laparoscopic or keyhole surgeries at Casey Hospital has also increased.

‘For the majority of kidneys we remove, we use laparoscopy. We can do just as good a job with laparoscopic removal; it’s less expensive, and patients don’t have to go elsewhere for the procedure. It’s a huge advantage.’

There are plans to extend the operating hours for robot-assisted surgery.

‘Currently, 4 half-days each week are used for robot-assisted surgery, with a planned increase of a further 6 sessions within 12 months.’

A new way to teach surgery

The robot’s dual-console set-up is also reshaping how the next generation of surgeons is trained.

‘Pelvic surgeries are notoriously difficult to teach because only one person can see what’s happening at any one time. Teaching is much easier on a dual console. It’s revolutionising the teaching and learning paradigm,’ said Dr Donnellan.

That dual-console training is being used for current clinicians upskilling on the technology as well as registrars, particularly for cancer cases and other complex procedures.

Positive impact

Dr Donnellan says the growth of the program has been a hospital-wide effort in one of the expanding sites within Monash Health.

‘It’s based at Casey Hospital and signals the development of this site as a tertiary service within Monash Health. It is now also a significant site for robotic surgery in Victoria.’

Theatre staff have adapted quickly, with 17 nurses trained on the technology alongside technicians managing the equipment.

The impact on recovery has been striking. Wards have embraced a 24-hour discharge policy for robotic prostatectomy patients, which is a dramatic shift from previous practice.

‘More than 90% of robotic prostatectomy patients are now discharged within 24 hours. Previously that was 3.5 days,’ Dr Donnellan said.

‘Blood transfusion rates have fallen from 15% to zero. Unplanned ICU admissions after surgery have fallen from 14% to zero. The whole recovery pathway for patients has completely changed.’

Meeting national training standards

The shift towards robotics also reflects changing expectations set by the profession’s governing body.

‘In terms of training future urologists, the Board of Urology at the Royal Australasian College of Surgeons (RACS) expects robotics to take over from open radical prostatectomy as a core, mandatory requirement of advanced training in Australia, and we’re completely compliant with that,’ Dr Donnellan said.

Care that follows patients home

Asked what it has meant for patients directly, Dr Donnellan pointed not just to the surgery itself, but to the care built around it.

‘It integrates very well with the prostate cancer pathway, offering a streamlined approach to patient evaluation and care. Our prostate cancer nurses offer a reference and education point for patients,’ he said.

Central to that is the hospital’s post-operative, nurse-led survivorship clinic, a service Dr Donnellan says is unique among Australia’s public hospitals.

‘It remains the first and only public hospital nurse-led prostate cancer survivorship clinic in Australia. We’ve been running it since 2019,’ he said.

The clinic supports patients after surgery with issues that can follow prostate removal, including continence and erectile dysfunction. These are problems that can otherwise leave patients without a clear point of contact once their treatment is formally complete.

‘One of the great barriers is that once patients fall outside the hospital walls, they can’t reach a doctor or nurse. This offers more personalised care, so patient satisfaction has improved incredibly,’ Dr Donnellan said.

Patients who have surgery and clear Prostate-Specific Antigen (PSA) results are automatically referred into the pathway, which runs across Monash Health’s Casey and Moorabbin urology outpatient clinics.

Casey Hospital is one of 7 hospitals operated by Monash Health.

Dr Scott Donnellan will be speaking more about the surgical robot and the huge impact it has on delivering world-class care for our patients during Monash Health’s Research and Innovation Week from 7 to 11 September 2026.

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