The numbers stop you cold. Prostate cancer is the most commonly diagnosed cancer among South African men across all population groups, with one in every 16 men facing this diagnosis in their lifetime according to the 2023 National Cancer Registry. But scratch beneath that headline figure and the picture turns considerably more troubling. For black South African men, the lifetime risk climbs to one in four. The mortality rate in this region sits at 2.7 times higher than the global average.
Behind these statistics, something is shifting in operating theatres in Pretoria and beyond. A technological transformation is quietly gathering momentum, offering precision that simply wasn't possible a generation ago.
Dr Julius Jacobs has seen too many cases where men walk into his consulting room with disease that has already spread. "The difficulty with prostate cancer is that it typically doesn't announce itself," says the Pretoria-based urologist, who practices at Life Wilgers Hospital. "By the time symptoms appear, we're often dealing with advanced disease where our options become more limited. Men need to understand that waiting for signs is waiting too long."
According to the first comprehensive study of its kind, Africa now sees urological procedures accounting for fully 90.1% of all robotic surgeries performed on the continent.
The most telling figure within that? Robotic prostatectomy represents 49.3% of all robotic procedures in Africa. Nearly half of every robot-assisted surgery performed across the three African countries with established programmes: South Africa, Egypt, and Tunisia, is aimed at the prostate.
The Numbers That Matter
The data emerging from these pioneering programmes deserves close attention. A meta-analysis published in the Journal of Minimally Invasive Surgery in September 2024 examined 1,328 procedures performed across the three countries using robotic platforms like da Vinci, in which Dr Jacobs is trained and accredited.
The findings are worth setting out clearly:
- Conversion rate to open surgery: Just 0.21% (95% CI, 0%–0.54%). This means that in 99.79% of cases where surgeons committed to the robotic approach, they were able to complete the procedure as planned.
- Morbidity prevalence: 21.15% (95% CI, 7.45%–34.85%). This figure captures complications ranging from minor to severe, and needs to be understood in context—it compares favourably with traditional surgical approaches.
- Mortality: Zero reported cases across all 1,328 procedures.
"These outcomes highlight successful implementation and the potential for wider adoption," the study authors concluded. They called for "multidisciplinary and multinational collaboration, investment in surgical training programs, and policy initiatives aimed at addressing barriers to the widespread adoption of robotic surgery in Africa."
Why This Matters for South African Men
South Africa carries a burden that stands out even among its BRICS peers. A 2024 study published in the European Journal of Cancer Prevention examined prostate cancer mortality across the bloc and found that South Africa recorded the highest age-standardised mortality rate—42.241 per 100,000—and the highest age-standardised DALY (disability-adjusted life years) rate at 666.085 per 100,000.
Prostate cancer accounts for 13% of all male cancer deaths in the country. And critically, the disease is "more likely to be hereditary in Black African men, leaving them disproportionately affected."
Dr Jacobs sees the implications of family history every week in his rooms. "When a man's father or brother has had prostate cancer, his own risk roughly doubles," he explains. "If multiple relatives are affected, that risk climbs further. These are the men we need to reach with screening, because we can catch this disease while it's still confined to the prostate and treatable."
The FDA Milestone That Validates the Approach
While South African surgeons have been quietly building their caseload and their experience, a significant regulatory development in the United States has put a powerful marker down for the technology.
In June 2024, the FDA cleared a labelling revision for the da Vinci system, removing a precautionary statement that had been in place for years. The agency now explicitly notes that radical prostatectomy was evaluated for overall survival. This followed a retrospective study of nearly 25,000 patients demonstrating that five- to ten-year overall survival following robot-assisted radical prostatectomy is comparable to traditional open surgery.
The Wider Context: Africa's Robotic Surgery Landscape
The adoption of robotic surgery in Africa presents "a nuanced picture, one interwoven with the continent's unique healthcare challenges and socioeconomic realities," the Journal of Minimally Invasive Surgery study notes.
The obstacles are real and substantial. A 2023 World Health Organization report found that approximately 60% of hospitals in Sub-Saharan Africa face regular power outages, while 15% of facilities lack any access to electricity—factors that "significantly impact the feasibility of adopting advanced surgical technologies like robotic systems."
Yet despite these constraints, South Africa, Egypt, and Tunisia have pushed ahead. The da Vinci platform, developed in the United States in 1995, remains the dominant system globally.
What This Means for Patients
For a South African man coming to terms with a prostate cancer diagnosis, the emergence of robotic surgery offers something tangible. It offers precision measured in millimetres. It offers recovery times measured in days rather than weeks. It offers survival outcomes now validated by the FDA and documented in African populations.
Dr Jacobs puts it plainly. "Prostate cancer is operated robotically." For those facing the diagnosis, that short sentence translates into options that simply didn't exist for their fathers' generation.
For the one in 16 South African men who will face this diagnosis, that represents hope. Not hope built on vague promises, but on precision, data, and a quiet revolution unfolding in operating theatres across the country.
Source Guide: Robotic Surgery and Prostate Cancer in South Africa
- 1. Cancer Association of South Africa (CANSA) – Prostate Cancer Information. Available at: https://cansa.org.za/prostate-cancer/ (Accessed: 2026). Citing 2023 National Cancer Registry data: lifetime prostate cancer risk for South African men is 1 in 16; prostate cancer is most commonly diagnosed cancer among South African men of all races; hereditary patterns in Black African men; family history doubles risk.
- 2. Journal of Minimally Invasive Surgery – "Analysing the emergence of surgical robotics in Africa: a scoping review of pioneering procedures, platforms utilized, and outcome meta-analysis." September 2024; 27(3):142-155. Available at: https://www.kci.go.kr/kciportal/ci/sereArticleSearch/ciSereArtiView.kci?sereArticleSearchBean.artiId=ART003117989. Data: urological procedures account for 90.1% of all robotic surgeries in Africa; robotic prostatectomy represents 49.3% of all robotic procedures in Africa; 1,328 procedures examined across South Africa, Egypt, Tunisia; conversion to open surgery 0.21%; morbidity 21.15%; zero mortality; platforms: da Vinci, Versius, Senhance.
- 3. European Journal of Cancer Prevention – "Prostate cancer burden in major BRICS countries, 1990–2019: findings from the 2019 global burden of disease study." January 2025; 34(1):83-88. Available at: https://journals.lww.com/eurjcancerprev/Abstract/2025/01000/Prostate_cancer_burden_in_major_BRICS_countries,.10.aspx. Data: South Africa highest age-standardised mortality rate among BRICS nations: 42.241 per 100,000; highest age-standardised DALY rate: 666.085 per 100,000.
- 4. Urology Times / Intuitive Surgical – "FDA clears labelling revision on da Vinci X and Xi for radical prostatectomy." June 5, 2024. Available at: https://www.urologytimes.com/view/fda-clears-labeling-revision-on-da-vinci-x-and-xi-for-radical-prostatectomy. Data: June 2024 FDA labelling revision; radical prostatectomy now explicitly evaluated for overall survival; retrospective study of nearly 25,000 patients; 5- to 10-year survival comparable to open surgery.
- 5. World Health Organization (via NIH/PubMed Central) – "Solar panels bring power to rural health facilities." Bulletin of the World Health Organization. November 1, 2023; 101(11):686-687. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC10630728/. Data: approximately 60% of hospitals in Sub-Saharan Africa face regular power outages; 15% of health facilities lack any electricity access.
- 6. Medpages – Dr Julius Jacobs – Urologist Profile. Last updated June 17, 2025. Available at: https://www.medpages.info/sf/index.php?page=person&personcode=18297. Data: accredited Da Vinci Robotic Surgeon; practice at Life Wilgers Hospital, Pretoria; Mmed dissertation University of Pretoria on prostate cancer outcomes; diploma in laparoscopic surgery University of Strasbourg; overseas training Cambridge for male erectile restoration and incontinence; practice website states "Prostate cancer is operated robotically."
- 7. African News Agency – "Fighting SA's most common male cancer." September 11, 2025. Available at: https://africannewsagency.com/fighting-sas-most-common-male-cancer/. Data: prostate cancer causes 13% of all male cancer deaths in South Africa; for black South African men, lifetime risk 1 in 4; mortality rate 2.7 times higher than global average.