March of the medical robots

Keyhole – or laparoscopic – surgery has been the buzz-phrase in cutting-edge surgery – if you’ll excuse the pun. Until recently. Today robots are giving surgeons a speedier, more efficient way to perform pouch operations, reports Christopher Browne.

Danilo Miskovic, St Mark’s Hospital’s lead robotic surgeon

If you want to liven up a dull dinner party or even a high-level business meeting – and who doesn’t! – mention robots. Once coveted by filmmakers and sci-fi lovers, the march of the robots is revolutionizing our approach to almost everything from domestic chores to high-end technology. 

And, hold on a minute, there have been rumors spreading through the hospital wards at St Mark’s about a group of surgeons and a …… robot! It’s just robotic gossip you might say, but you’d be wrong for it’s all true.

For almost two years now a team led by Professor Omar Faiz, St Mark’s Hospital’s clinical director, has been pioneering a research programme into robot technology, financially backed by a St Mark’s Hospital Foundation fundraising campaign.

The campaign funded the capital costs of the purchase of a Da Vinci Xi surgical robot – the most advanced of its kind in the world – in March 2018. Just a month after the robot’s delivery, a group of St Mark’s surgeons performed the hospital’s first robotic operation on a bowel cancer patient.

As the UK’s first hospital to use robot technology almost exclusively for bowel surgery, St Mark’s has carried out 180 plus robotic operations on mainly bowel-related cases. “We set ourselves the goal to perform 80 robotic colorectal operations in our first year and we easily exceeded this target. One of the cases was particularly unique: it involved two surgeons operating robotically on both a patient’s bowel and liver during the same operation,” said Jason Bacon, CEO of St Mark’s Hospital Foundation. 

Another “first” occurred In August this year when a team of four surgeons, including Mr Danilo Miskovic, St Mark’s lead robotic surgeon, carried out a 12-hour pelvic exenteration [an operation to remove multiple organs in the pelvis] on a young father with cancer which had been caused by complications with ulcerative colitis. 

Two months later, a team headed by Prof Faiz and Mr Miskovic, performed the first-ever robotic ileoanal pouch surgery on a St Mark’s patient.

“We believe the introduction of robotic surgery is an important milestone in reducing the risk of recurrent disease, and provides patients with a good short- and long-term quality of life. Similar to laparoscopic surgery, it is minimally invasive but it also provides the surgeon with magnified, high-definition 3d images to enable extremely precise surgery,” said Mr Bacon.

“While robotics has been established in other surgical specialties, namely urology and gynecology, its application has not until recently been widely researched and implemented for bowel disease surgery.”

Since the robotic surgical programme began, St Mark’s bowel cancer surgeons have been training to use the robotic surgical tool, while a fellowship in robotic surgery, funded by Intuitive Surgical, supplier of the Da Vinci Xi robot, will train more surgeons in the next three years.

Operation robot: a St Mark’s team carry out robot-assisted surgery

This article first appeared in ISSUE 58: Christmas 2019 edition of ROAR!

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Gary Bronziet