• The Rotary Club of Pinjarra welcomed Doctor Matthew Brown as Guest Speaker at their meeting on 12th of January. Matt was introduced to the meeting by Rotarian Duncan Hiles, a former patient of Matt's.

Matt Brown assists patients with all manner of Urological problems, but has a subspecialty interest in robotics, prostate cancer, and Academic surgery. Matt is a graduate of the University of Western Australia, where he completed his medical degree and a PhD in Surgery. In addition to his training in Urology, Matt has undertaken an internationally competitive fellowship in robotics, and worked as a consultant Urologist/Robotic Surgeon at the world famous Guy’s Hospital in London.

Matt returned to Perth in 2015, and took up a substantive appointment at Fiona Stanley Hospital, and private practice at Perth Urology Clinic. Aside from looking after his own patients, Matt has a passion for teaching robotic surgery, and frequently flies interstate to mentor other surgeons. Matt titled his discussion – Robots and the Prostate.

Leonardo Da Vinci made the first robot in 1495. Called "Leonardo's Mechanical Knight", it was a humanoid automaton whose movement was based on a pulley system. Robots (the term comes from a Slavic root, robot-, with meanings associated with labor) nowadays are highly complex machines using Artificial Intelligence. The evolution of the  use of robotic assistance when performing surgery includes the use of internet technology where this connectivity is enabling remote operations to be performed.
Matt discussed many of the various advanced Robots now used for surgery world-wide.
The "Da Vinci" robot (manufactured by Intuitive Surgical) is the machine used for most surgical procedures performed with robotic assistance on the prostate in Perth.
Matt discussed the elements of the Da Vinci robot which make the process of surgery safer for the patient. This includes that advantage of removing the element of physical stress that a surgeon experiences when conducting an operation without robotic assistance. Surgical "accidents" are significantly reduced by the use of robotic assistance.
In short – instruments can surpass human movement.
Capabilities of the modern surgical robots include:
  • Telepresence- the use of virtual reality technology, especially for remote control of machinery or for apparent participation in distant events.
  • Fluorescence- Fluorescent imaging on robotic systems is intended to perform minimally invasive surgery using standard endoscopic visible light as well as near infra-red imaging for visual assessment of vessels, blood flow and related tissue perfusion.
  • Image guidance- The use of any form of medical imaging to plan, perform, and evaluate surgical procedures and therapeutic interventions.
  • Simulation- Making it possible to both visualize and quantify how changes in system components will influence image quality.
  • 3D-HD endoscope- providing a 3-dimensional picture, which supposedly gives additional information of depth, anatomical details and orientation in the surgical field.
  • Robotic Instruments- allowing a surgeon to perform delicate operations by manipulating the robotic arms, which translate the surgeon's hand movements into smaller and smoother strokes.
Matt believes that Urologists lead the way with the use of robot-assisted instruments when performing surgical procedures. This is particularly apparent when once considers how much the use of this mode of surgical technique has increased to perform prostatectomy procedures. Prostatectomy is surgery to remove part or all of the prostate and some of the tissue around it, including the seminal vesicles (a gland that helps make semen). Nearby lymph nodes may also be removed.
Which introduces Matt's second topic for discussion this evening: The Prostate Gland.
The prostate gland is about the size of a walnut and surrounds the neck of a man's bladder and urethra—the tube that carries urine from the bladder. It's partly muscular and partly glandular, with ducts opening into the prostatic portion of the urethra. It's made up of three lobes, a center lobe with one lobe on each side. Researchers don't know all the functions of the prostate gland. However, the prostate gland plays an important role in both sexual and urinary function. It's common for the prostate gland to become enlarged as a man ages, and it's also likely for a man to encounter some type of prostate problem in his lifetime.

Many common problems that don't require a radical prostatectomy are associated with the prostate gland. These problems may occur in men of all ages and include:

  • Benign Prostatic Hyperplasia (BPH)-  This is an age-related enlargement of the prostate that isn't malignant. BPH is the most common noncancerous prostate problem, occurring in most men by the time they reach their 60s. Symptoms are slow, interrupted, or weak urinary stream; urgency with leaking or dribbling; and frequent urination, especially at night. Although it isn't cancer, BPH symptoms are often similar to those of prostate cancer.

  • Prostatism. This involves decreased urinary force due to obstruction of flow through the prostate gland. The most common cause of prostatism is BPH.

  • Prostatitis. Prostatitis is inflammation or infection of the prostate gland characterized by discomfort, pain, frequent or infrequent urination, and, sometimes, fever.

  • Prostatalgia. This involves pain in the prostate gland, also called prostatodynia. It's frequently a symptom of prostatitis.

Prostate Cancer is a disease which creeps up on you. It is the second biggest killer of men.  When a man receives a diagnosis that confirms a prostate cancer, removal of the gland is the most common treatment. There are different ways to achieve the goal of removing the prostate gland when there's cancer.
Diagnosis is usually first indicated by way of a blood test to measure the patient's PSA (Prostate Specific Hormone). A "normal" blood PSA value is less than 2, and a physician will begin investigating a patient is he returns two consecutive PSA tests of a value of 3 or more. The diagnosis would be confirmed by way of conducting a biopsy (that is an examination of tissue removed from a living body to discover the presence, cause, or extent of a disease), of the patient's prostate.
Matt's message to the meeting is simple: Men, let's be smart with our health. The acrnonym MEDS reminds us that we all need to be aware of, and pay attention to:
  • M - Mental Health
  • E - Exercise
  • D - Diet
  • S - Sleep
As well as a man's PSA  history being important, the patient's family history is also important.
Matt answered a number of questions from the floor of the meeting, before being thanked for his very interesting talk by Bernie Hiles. She also thanked Matt for the personal care he offered when he operated on Duncan.
The meeting was closed with the singing of the Australian National Anthem.