Milestone reached in NNUH robotic-assisted surgery
Consultant surgeons have reached a significant milestone in the development of robotic surgery at the Norfolk and Norwich University Hospital.
NNUH was the first hospital in East Anglia to perform robotic colorectal cancer surgery, in 2017 after robots were introduced into the Trust in 2016.
Since then, surgeons have carried out more than 3,000 robotic assisted procedures in urology, gynaecology, thoracic, ENT and colorectal surgery. Colorectal robotic surgery is carried out by Colorectal Consultant Surgeons Professor Irshad Shaikh, Jamasp Dastur and James Hernon and the Colorectal Surgery department welcomes visiting surgeons from across Europe.
Irshad Shaikh, who has been instrumental in developing the use of robots in surgery, said: “We have been steadfast in our ambition to become a centre of excellence in terms of carrying out robotic procedures and in teaching other surgeons, from all over Europe and the world.
As NNUH resident Proctor (someone who oversees the procedure as an expert in that field), Irshad is one of the first surgeons in the country to support Intuitive Telepresence, which means interested professionals can follow a procedure in real-time, with patient consent, from anywhere in the world.
He said: “Robotic surgery has helped us improve our outcomes and provide a better experience for patients. As patients come back to clinic for review, they tell us that they are able to get back to their normal day-to-day lives more quickly. The dexterity of the instruments is unparalleled and a significant number of patients are able to go home after two days and recently we started a 23-hour discharge programme for selected patients with the support of the Virtual Ward.
“We celebrate this milestone and I am proud of all the teams who have made this possible. With each surgery we perform we continue to learn and develop our expertise. We are now looking to expand the use of robotic-assisted procedures to other specialties.”
Complex robotic surgery including robotic exenteration for advanced rectal cancer is another area we are at the forefront of. One patient who has benefited from this expertise is 76-year-old Alan Forster from Horsford. Alan was treated for bowel cancer a year ago and after a follow-up scan to monitor his recovery, it was discovered that he also had cancer in his bladder, prostate and rectum.
He underwent major robotic surgery in a 10-hour operation to remove the cancerous tissue and take tissue from four muscles in his legs to fill in the pelvic cavity to reduce the risk of a hernia.
A team of five surgeons, nurses, anaesthetists, health care assistants in colorectal surgery were led by Irshad who performed the surgery in January 2023.
This sort of complex exenteration-type surgery is done in selected centres in the UK. We perform them robotically with the help of the urology and plastic surgical teams. A robotic approach reduces the morbidity, blood loss and no large incision from chest to abdomen needed. This helps in faster recovery. Alan went home after two weeks and a previous patient was well enough to go home in a week, compared to much longer stays if this were performed with open surgery.
Irshad said: “We have a unique approach in reducing the theatre time by working with plastic surgeons at the same time as the robotic part of the procedure is carried out. This approach took two-three hours off the procedure.
Alan, who was keen to leave hospital, was able to go home after two weeks as opposed to the usual three to five-week hospital stay, as his wife Sharon would be his primary carer.
Alan, who has only 10% of his sight, said: “It was quite a shock to hear the original diagnosis of bowel cancer. Then when you think you’re going to be told they have got it all and you are clear, they told me I had three other cancers.
“They told me it was major keyhole surgery with a robot. I came out after a fortnight, which is just incredible really. It’s just amazing what they can do now.
“They did say by doing it this way that my recovery would be so much faster. There have been some difficulties along the way, but I am getting there. Professor Shaikh told us that I had to do lots of walking, and I am doing that. I have started my bucket list with a climb of Beeston Bump and my next one is the entire circuit of the UEA lake – I might even go round twice.”
Sharon goes on the long walks with Alan, encouraging him to “walk, walk, walk.”
She said: “Professor Shaikh said the key is walking. He told us to walk when we feel able and to keep going until we feel we can’t. Recover – then do it again.”
Sharon heaped praise on Irshad for the innovation he brought to Alan’s case and the faith he put in the couple.
She said: “It’s amazing to see Alan now. What Professor Shaikh has done for him, what the whole team has done for him is amazing. He told us exactly what to expect and told us we could do it. He put so much faith in us. It was quite overwhelming, and I am a person who doesn’t dwell on things, I prefer to get on with it. He got to know us and is one of the most inspiring people I have met. These advances are just out of this world.”
Development of robotic assisted surgery at the Trust has been supported by N&N Hospitals Charity which provided a £1 million grant, enabling the purchase of a second robot.
Julie Cooper, Head of Grants for the Norfolk and Norwich Hospitals Charity said: “We were really pleased to be able to support the development of our robotic surgery with a grant for one of the state-of the art robots. Learning that more than 3,000 procedures have been performed at the Trust is wonderful news. Thank you to everyone who donated and made it possible for us to support better care for our patients.”
To find out more about the N&N Hospitals Charity or to make a donation please visit www.nnhospitalscharity.org.uk
You can follow the Charity on social media @nnhospcharity