Mr Nicholas Penney, Consultant Oesophagogastric Surgeon, performed the 14-hour operation on 54-year-old Lee Moreton as part of his treatment plan for cancer.

It was the first fully Robotic Assisted Minimally Invasive Oesophagectomy (RAMIO) performed here which has become one of only five sites across the UK to offer this highly specialist surgery.

An oesophagectomy is a two-stage procedure performed within both the abdomen and chest. Both stages of the procedure, to remove a tumour from Lee’s oesophagus, were carried out robotically. He was discharged just five days after his surgery, two days earlier than usual after an oesophagectomy, and with no complications.

Traditionally, the procedure is performed either through open surgery, leaving much larger wounds, increased risk of infection, pain and a longer recovery time or minimally invasive laparoscopic and thoracoscopic techniques, which our Oesophagogastric team has been at the forefront in developing. Nationally, the average length of stay for oesophagectomy patients ranges from seven to 13 days across different centres. We have an excellent track record, with a current average length of stay of seven days, one of the top performing centres in the country. The hope is that a robotic approach will help improve recovery further still for patients.

Robotic-assisted surgery has benefits for patients over previous techniques, including reduced pain and blood loss, shorter hospital stays and quicker recovery times. The surgery requires only very small incisions, which are possible thanks to the use of miniaturised cameras and instruments, controlled remotely by a surgeon, via the robotic system’s console. This allows greater visibility and precision than would be available in conventional techniques, making procedures easier for surgeons and safer for patients.

Nicholas said: “The case was very challenging due to the tumour being densely adhered to the lining of the heart and airways following radiotherapy treatment. Previously this would have necessitated the procedure being performed through an open thoracotomy incision. However, the improved 3D vision, dexterity and precision of the robot allowed the procedure to be performed minimally invasively through small incisions. The hope is that this type of robotic surgery will continue to reduce complications such as pneumonia following surgery, reduce length of stay and aid in a quick return to full function for our future oesophagectomy patients.”

Lee had previously had surgery for bowel cancer six years ago and was given all clear last year. However, he contacted his GP last August after suffering new symptoms of struggling to swallow. An endoscopy revealed a tumour in the oesophagus. He is now recovering at home after his surgery and is waiting to find out the next steps of his treatment plan.

He said: “I can’t believe the general lack of pain and the mobility I have after surgery, it’s absolutely fantastic. I had open surgery years ago and that was much more difficult to deal with. I was told I’d be in a least a week so to go home after five days was great. It’s amazing what is available now.”

Alex Allen, Clinical Lead for Perioperative Theatre Equipment and Robotic Surgery, added: “It is an honour to be able to contribute to the care of a patient when they are at their most vulnerable, ensuring all their needs are met and that we maintain high standards of practice. With the development of robotic surgery here at NNUH, we are able to improve the patient’s outcome with the innovative technology the system provides. As the Clinical Lead for robotic surgery, I’m excited to be involved in the expansion of this service and continue to develop our knowledge and skills.

“I would also like to take this opportunity to thank the surgical team. They show such integrity and dedication to the care of the patients every day, on many occasions staying beyond their time to ensure the patient’s needs are met.”

Catherine Hainey, Dilham Ward Manager, added: “From a nursing perspective, this is an incredible achievement to be part of an amazing MDT team. Oesophagogastric cancer is so impactful for our patients, sometimes changing every aspect of their lives. Being able to offer less invasive and less painful surgical interventions will hopefully mean we can work with our patients to reach their goals of getting home to their families faster and with fewer complications, which is what we all want for our patients.”

Bernard Brett, Medical Director, said: “I would like to thank our entire upper GI surgical team in developing and implementing the Robotic Minimally Invasive Oesophagectomy service. The advantages of this advanced surgical approach for our patients are truly significant and we are committed to developing this type of service further so more of our population can benefit from it.”

The Norfolk and Norwich Hospitals Charity is running an appeal to fund two new robots to help deliver more specialist surgery. To find out more or to contribute, visit their just giving page.