Robotic-Assisted Surgery Improves Patient and Surgeon Experience

Robotic-assisted surgery uses an array of robotic arms, on which are mounted a range of specialised laparoscopic instruments and a powerful camera. The system is operated by a surgeon via a console, allowing them to conduct surgery in a minimally invasive manner. The camera utilised by the robotic surgery system provides high-definition 3D imaging, which is magnified at the surgeon’s console to 10 times the size seen by the human eye. This affords the operating surgeon a far clearer view than is available in traditional surgery.

By conducting surgery using laparoscopic instruments, controlled remotely via the robotic system’s console, surgeons can operate more easily on areas that are difficult to reach when operating manually. The combination of smaller instruments and the enhanced visibility provided by the system’s camera also means surgeons can be far more precise than when operating without the system’s assistance. Robotic-assisted surgeries therefore require only very small incisions, making procedures safer for patients by reducing blood loss, infection risks and recovery times.

Robotic-Assisted Surgery at NNUH

In recent years, the Robotic Surgery team at NNUH has grown significantly in scope and capacity with the support of the N&N Hospitals Charity. The team is now a pioneering force in the development of robotic-assisted surgery on an international scale. This means NNUH is ideally positioned to lead future developments in this innovative surgical method.

Robotic-assisted surgery has been taking place at NNUH since 2016, when the Hospital’s first da Vinci surgical robot was purchased for use in prostate cancer surgery. After initially being used by the Urology team, the robot was later implemented in colorectal procedures as well. In 2017, NNUH became the first hospital in East Anglia to carry out robotic-assisted bowel cancer surgeries.

In 2020, NNUH’s original surgical robot was replaced by two newer models. These allowed more complex urology and colorectal procedures to take place, while also extending the use of the robotic systems to gynaecology, thoracic, and head and neck surgery. This expansion of knowledge around the surgical robotic systems, alongside the implementation of newer models of robot, opened the door to new training opportunities. In 2021, NNUH became the first hospital in the UK to deliver a robotic surgery training programme to surgical registrars.

The educational benefit of the surgical robots was further extended in 2022, with the integration of Intuitive Telepresence. This educational tool allowed surgeons at NNUH to live-stream robotic surgical procedures for the benefit of trainees and other surgical staff, leading to training from the Hospital being delivered remotely to surgeons around the world. Thanks to the pioneering implementation of robotic-assisted surgeries at NNUH, surgeons at the Hospital have been able to lead the way in training others globally.

Professor Irshad Shaikh, Proctor and lead Robotic Surgeon at NNUH, said of the training programme:

In recognition of the success of the robotics programme at NNUH, Professor Shaikh was selected to attend the Royal Party celebrating the 75th anniversary of the NHS.

To date, around 4,000 robotic-assisted procedures have been carried out at NNUH, with 828 procedures carried out in 2023 alone. Data from Intuitive, the robots’ manufacturer, indicates that the two robots at NNUH are currently in the top 5% of the most used robots in the UK. 18 surgeons at the Hospital have so far been trained to use the robotic system. However, there is still room to further develop the Hospital’s capacity to deliver robotic-assisted surgery. We are now aiming to extend the reach of this pioneering work to additional specialities at NNUH, so that more of our patients can benefit from the wealth of expertise that has already been established within NNUH’s Robotic Surgery team.

Benefits of the Surgical Robots

The two robots currently in use at NNUH have already demonstrated clear benefits to patients and staff. The introduction of two additional robots at the Hospital would build upon these benefits, extending the advantages of robotic-assisted surgery to more areas of the Hospital.

The greatest benefits provided by robotic-assisted surgery are:

• Minimally invasive surgery, requiring only very small incisions, means blood loss is reduced and recovery times are far shorter, allowing patients to return to their normal day-to-day lives sooner.

• The use of laparoscopic cameras and instruments, controlled remotely via the robotic system’s console, affords surgeons greater visibility and precision than would be available in conventional open surgery. This makes procedures easier for surgeons and safer for patients.

• Faster recovery times result in shorter hospital stays, improving the availability of beds and resources for patients and reducing waiting lists for surgical procedures. Purchasing new robots for use at the Hospital will further grow this benefit, allowing more patients to receive robotic-assisted surgery and earlier discharges from hospital.

• The robot’s ability to record and live-stream images for educational purposes means that the knowledge base being established at NNUH is supporting surgeons and other hospitals all around the world. The introduction of two new robots will support the growth of the NNUH Robotic Surgery team’s capabilities, which will in turn benefit patients everywhere through our global training programme.

• Introducing additional robots at NNUH will mean the advantages of robotic-assisted surgery can be passed on to patients for whom this is not currently an option, including children undergoing paediatric surgical procedures.

Expanding the Scope of Robotic-Assisted Surgery at NNUH

To grow NNUH’s capacity to offer robotic-assisted surgery and to deliver training globally in this field, we are planning to purchase two new surgical robots. As well as supporting the robotic-assisted procedures currently taking place in the Hospital’s Urology, Colorectal, Gynaecology, Thoracic and ENT Departments, the new robots will be utilised in Upper and Lower GI surgery, Plastics and Paediatrics.

Introducing two new robots at NNUH will mean more patients are able to undergo these safer, less invasive procedures. This will ensure better surgical outcomes, resulting in shorter hospital stays and a reduced need for additional support post-surgery. This in turn will mean hospital appointments and clinical resources are made more accessible for everyone in NNUH’s community.

Expanding the Hospital’s work in robotic-assisted surgeries will also further develop NNUH’s capabilities as a centre of excellence in education and training. With more specialities across the Hospital being trained to implement robotic-assisted surgical techniques, we aim to establish a broader knowledge base to inform the training being delivered from the Hospital to surgeons worldwide. The purchase of additional robots for use at NNUH will also expand the Robotic Surgery team’s capacity to deliver training, maximising the Hospital’s impact on surgical proficiency regionally, nationally and internationally.