Updates on pioneering procedures, advanced technologies, and milestones in urological surgery.
Milestone
First Pure Single Port Robotic Procedure in NSW
Dr Raji Kooner successfully completed the first pure single port robotic procedure in NSW — a true single-incision approach without any assisting ports — with support from Dr Ryan Nelson (USA).
Read full story
Last week, Dr Raji Kooner successfully completed the first pure single port robotic procedure in NSW using a true single-incision approach, without the addition of any assisting ports.
The patient's post-operative recovery was uneventful, with excellent early clinical outcomes and minimal discomfort, reflecting the benefits of this next-generation minimally invasive technique.
This milestone procedure was performed with the support and training of Dr Ryan Nelson (USA), an internationally recognised leader in single port robotic surgery.
While some surgeons describe their technique as "single port," many still introduce an additional assisting port. In contrast, this case represents a true pure single port procedure, performed entirely through a single small incision.
By introducing this advanced approach into Australia, Dr Kooner continues to lead innovation in robotic prostate surgery.
Recognition
APAC's Highest iTind Implanter — Over 50 Procedures
Olympus Australia & New Zealand has recognised Dr Kooner for completing the most iTind procedures in the Asia-Pacific region to date.
Read more
We're proud to share that Olympus Australia & New Zealand has recognised Dr Raji Kooner for completing greater than 50 iTind procedures — the most in the Asia-Pacific region to date.
Training
Hands-On Single-Port Training at Intuitive HQ, California
Dr Kooner completed a one-on-one laboratory training program on the new single port system at Intuitive Surgical's headquarters in Sunnyvale, California.
Read more
Dr Raji Kooner completed a one-on-one laboratory training program on the new single port system. This advanced approach enables surgery through a single small incision, aiming to reduce discomfort, speed recovery, and improve cosmetic outcomes.
By bringing these techniques home, Dr Kooner continues to offer Australian patients access to leading-edge, minimally invasive prostate cancer care.
Innovation
Pioneering Single Port Robotic Surgery in Australia
Dr Kooner is one of the first surgeons in Australia to introduce the single port robotic system, offering patients a procedure through a single small incision.
Read more
Dr Raji Kooner is one of the first surgeons in Australia to introduce the single port robotic system for prostate surgery. This advanced approach allows the procedure to be performed through a single small incision, with the aim of reducing discomfort, speeding recovery, and improving cosmetic outcomes.
Dr Kooner undertook specialised training in San Francisco, USA, working alongside internationally recognised experts in robotic surgery. By incorporating these techniques into his practice, he is able to offer patients access to the latest developments in minimally invasive prostate cancer treatment.
Milestone
A Historic Milestone in Australian Robotic Surgery
Mr. Langford, New South Wales' first robotic prostate surgery patient, reunites with Dr. Raji Kooner years after their groundbreaking operation.
View story
Mr. Langford, New South Wales' first robotic prostate surgery patient, reunites with Dr. Raji Kooner — his pioneering surgeon — years after their groundbreaking operation.
Procedure
Transperineal Prostate Biopsy — MRI Fusion
Dr Raji Kooner explains transperineal biopsies and their application in diagnosing prostate cancer with MRI fusion technology.
Dr Kooner is one of the first urologists in Australia to perform iTind — a new minimally invasive therapy for BPH, preserving sexual and ejaculatory functions.
Read more
Dr Kooner has been implanting iTind since September 2022. He says: "The iTind is an important addition to our treatment portfolio, offering a less invasive treatment option with no major side effects."
The iTind procedure reshapes the anatomy of the prostatic urethra, gently creating a wider opening for urine to flow freely, without burning or cutting out tissue, and without leaving behind a permanent implant. It does not require overnight hospitalisation and preserves sexual and ejaculatory functions.
Video
Moses Laser Treatment — Featured on Channel 9
High tech treatment with Dr Raji Kooner featured on Channel 9, demonstrating the Moses laser approach for prostate conditions.
Watch video
Video
Men's Continence & Erectile Function After Surgery
Video by Stuart Doorbar-Baptist, Director at Sydney Men's Health, covering physiotherapy research at Sydney University and University of Queensland.
Powered by Convective Water Vapor Energy (WAVE) technology, Rezum applies thermal energy to safely treat lower urinary tract symptoms secondary to BPH.
New technologies and alternative treatments for prostatic diseases have resulted in fewer side effects, reduced morbidity, and improved patient outcomes.
A powerful diagnostic imaging tool far more accurate than other methods, improving the visualisation of lymph nodes and bones for personalised treatment strategies.
Learn more
PSMA PET/CT is a new diagnostic imaging tool that assists in initial staging (determining the extent of prostate cancer), and also restaging of a recurrence. It is far more accurate than other imaging methods, improving the way in which prostate cancer is diagnosed and treated.
The improved visualisation of lymph nodes and bones allows physicians to develop a personalised, targeted treatment strategy.
Video
UroLift Procedure Footage by Dr Raji Kooner
Watch video of the UroLift procedure to reduce prostate obstruction, performed by Dr Kooner.
Dr Kooner is one of the first in Australia to perform transperineal ultrasound-fusion guided biopsy, allowing more accurate targeting of MRI abnormalities.
Learn more
Dr Kooner is one of the first in Australia to perform transperineal ultrasound-fusion guided biopsy into the prostate. This technology allows more accurate biopsy with fusion of MRI abnormalities onto ultrasounds used in theatre, allowing abnormalities to be targeted more accurately.
Research
Multiparametric MRI — Changing Prostate Cancer Diagnosis
Multiparametric magnetic resonance imaging (mpMRI) is a powerful tool which is changing the landscape of prostate cancer detection and diagnosis.
Is the prostate cancer surgery you have chosen correct for you?
Dr Raji Kooner is in a unique position — he can offer patients the option of open, laparoscopic or robotic surgery.
Dr Kooner pioneered the Robotic Prostate Cancer Surgical Programme, performing the first case in NSW and 75% of all robotic radical prostatectomies in that first year. To date, he has performed over 2,000 robotic procedures.
If you would like Dr Raji Kooner to offer an opinion, complete the second opinion form. We will respond with advice about the choice of therapy for your prostate cancer. For a complete evaluation and a comprehensive treatment schedule, an appointment will be necessary. To organise a meeting, call our friendly staff on 02 8382 6980.
The Sydney Prostate Centre is dedicated to increasing awareness of prostate cancer in the community — offering information on reducing your risk, and surgery options for men already diagnosed. If you know of anyone that could benefit from this information, please pass it on.
Dr Kooner's strength is his surgical expertise and technical ability, particularly in minimally invasive surgery. He has extensive experience in open radical prostatectomy — this data has been presented at multiple conferences including the World Urology Conference (SIU 2004). He was heavily involved in laparoscopic prostatectomy and organised a major conference on the subject with the world expert, Dr Guilloneau, in 2004, and has presented his data at the NSW Urology Conference (2006) and the Australasian Urology Society Meeting (2007).
Data on his robot-assisted surgeries has been presented at the European Association Urology Conference 2009, the World Urology Conference SIU 2007, and the Australian Urology Conferences 2008 and 2009.
2,000+
Robotic Procedures
>90%
Discharged Day 2–3
80 ml
Avg. Blood Loss (vs >600 ml open)
0
Transfusions Required
Results are equivalent to published overseas10, 11, 12 series with excellent cancer control, urinary continence and erectile function. Patients benefit from more accurate, precise, minimally invasive surgery with exceptionally few complications.
Key Features of Dr Kooner's Experience
Performed the first robot-assisted radical prostatectomy in NSW, completing over 75% of cases in the first year
Completed over 2,000 robotic, minimally invasive prostate cancer surgeries to date
One of very few surgeons in NSW who does not select patients — operates on all cases, including difficult prostates, larger patients, and those with previous surgery
First Australian surgeon to perform a robot-assisted retrograde nerve-sparing prostatectomy, and the first to perform posterior reconstruction of the pelvic floor with the robot in Australia
The only robotic surgeon to routinely use intraoperative frozen sections — allowing real-time modifications if unexpected cancer is found beyond the prostate, significantly improving outcomes13
In over 2,000 radical robot-assisted prostatectomies, not a single patient has required a transfusion
Personally mentored by, and regularly visits, the major pioneers in robotic and laparoscopic surgery worldwide (see panel)
Mentors surgeons in robotic surgery both overseas and in Australia
Regularly presents at international conferences; actively involved in prostate cancer research
Continually reviews his operative data and outcomes
Have questions about robotic surgery?
Get an obligation-free second opinion from Dr Kooner. We guarantee a response within 7 days.
Obligation-free · Response within 7 days · All enquiries confidential
Welcome
This site provides an overall picture of a rapidly changing and highly important area of men's health prostate cancer and its effective treatment. A wide variety of information has been assembled here to aid patients, their families and their friends to quickly access vitally needed perspectives on the care of the prostate, including breakthroughs in minimally invasive approaches to prostate surgery.
Prostate Cancer
Prostate cancer is a very common condition; it was the most commonly diagnosed cancer in Australia in 2018.14 In 2022, it is estimated that a male has a 1 in 6 (or 17%) risk of being diagnosed with prostate cancer by the age of 85.14 For a large majority of these men, treatment for prostate cancer results in positive outcomes15 and a return to good health.
With greater awareness of the high incidence of the disease, it is now being found earlier and mortality rates are declining14. This fact, coupled with new medical treatment options, provide new promise for victims of prostate cancer. Your urologist will explain the range of options available to you to treat the disease.
da Vinci ® Prostatectomy
If your urologist recommends surgery to treat your prostate cancer, you may be a candidate for a less invasive approach to surgery called da Vinci® Prostatectomy. This approach to prostatectomy provides access to the internal anatomy through five small incisions. The surgeon is empowered to perform a very precise, nerve-sparing operation with the da Vinci ® Surgical System17. For the patient, da Vinci ® Prostatectomy may result in more complete eradication of cancer, retention of bladder control and potency.18
From Dr Kooner
Hi, I'm Raji Kooner, a senior consultant urologist at Sydney Prostate and Kidney Centre.
I've created this website to ensure that my patients and their families are better informed about the nature of their condition and the specific treatments available.
Here at the Sydney Prostate Cancer Centre my team is committed to providing technologically advanced, state of art care for all urological conditions and in particular, prostate disease.
I performed the largest series of holmium laser treatments for benign prostatic enlargement in Australia.
I performed the first robot assisted radical prostatectomy in New South Wales and 70% of the cases in the first year.
To date I have successfully completed over 2000 robotic procedures and my results have been presented nationally and internationally.
Please feel free to use this website to better understand how myself and my team can provide the highest standard of care for your condition.
To anyone who has a raised PSA or a diagnosis of prostate cancer I'm happy to provide a second opinion.
My team are committed to delivering this opinion within one week.
Again thank you very much for your interest and I hope you find this website useful.
All trademarks, copyright and ownership belong to their original owners, this website's contents copyright
References
Kadner G, Valerio M, Giannakis I, Manit A, Lumen N, Ho BSH, Alonso S, Schulman C, Barber N, Amparore D, Porpiglia F. Second generation of temporary implantable nitinol device (iTind) in men with LUTS: 2 year results of the MT-02-study. World J Urol. 2020 Mar 2. PMID: 32124019
De Nunzio C, Cantiello F, Fiori C, et al. Urinary and sexual function after treatment with temporary implantable nitinol device (iTind) in men with LUTS: 6-month interim results of the MT-06-study. World J Urol. 2021;39(6):2037-2042. doi:10.1007/s00345-020-03418-2
Elterman D, Alshak M, Martinez Diaz S, et al. An Evaluation of Sexual Function in the Treatment of Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia in Men Treated with the Temporarily Implanted Nitinol Device [published online ahead of print, 2022 Sep 7]. J Endourol. 2022; doi:10.1089/end.2022.0226
Kevin T. McVary, Marc C. Gittelman, Kenneth A. Goldberg - et al - Final 5-Year Outcomes of the Multicenter Randomized Sham-Controlled Trial of a Water Vapor Thermal Therapy for Treatment of Moderate to Severe Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia - Journal of UrologyAdult Urology, 1 Sep 2021 - https://doi.org/10.1097/JU.0000000000001778
Daniel H. Kwon, Ana I. Velazquez, Ivan de Kouchkovsky - PSMA PET Scan - JAMA Oncol. 2022;8(12):1860. doi:10.1001/jamaoncol.2022.3531
Petru Octavian Drăgoescu, Andrei Ioan Drocaș, Alice Nicoleta Drăgoescu - Transperineal Prostate Biopsy Targeted by Magnetic Resonance Imaging Cognitive Fusion - Diagnostics (Basel). 2023 Apr; 13(8): 1373. - doi: 10.3390/diagnostics13081373
Les C Thompson and Morgan R Pokorny - Multiparametric MRI in the diagnosis of prostate cancer – a generational change - Australian Family Physician - Volume 44, Issue 8, August 2015
Roehrborn CG, Gange SN, Shore ND, Giddens JL, Bolton DM, Cowan BE, Brown BT, McVary KT, Te AE, Gholami SS, Rashid P, Moseley WG, Chin PT, Dowling WT, Freedman SJ, Incze PF, Coffield KS, Borges FD, Rukstalis DB. Multi-Center randomized controlled blinded study of the prostatic urethral lift for the treatment of LUTS associated with prostate enlargement due to BPH: the L.I.F.T. study. J Urol 2013: Jun 10. pii: S0022-5347(13)04597-7. doi: 10.1016/j.juro.2013.05.116.
George EI, Brand TC, LaPorta A, et al. Origins of robotic surgery: From skepticism to standard of care. JSLS. 2018;22(4). e2018.00039
Guillaume Ploussard, Annabelle Grabia, Eric Barret - Same-day-discharge Robot-assisted Radical Prostatectomy: An Annual Countrywide Analysis - Eur Urol Open Sci. 2022 Feb; 36: 23–25 - doi: 10.1016/j.euros.2021.12.002
Felix Preisser, Lena Theissen, Peter Wild - Implementation of Intraoperative Frozen Section During Radical Prostatectomy: Short-term Results from a German Tertiary-care Center - European Urology Focus, Volume 7, Issue 1, January 2021, Pages 95-101
Patrick Probs - A Review of the Role of Robotics in Surgery - Mo Med. 2023 Sep-Oct; 120(5): 389–396
Gabriele Cozzi, Elisa De Lorenzis, Carlotta Palumbo, et al - Robotic prostatectomy: an update on functional and oncologic outcomes - https://doi.org/10.3332/ecancer.2013.355
