Robot operates on 1,000th prostate cancer patient

The Da Vinci robot has been compared in look to an old computer console or even a spider, but it has transformed the method and perception of how surgery is performed.

In November 2008, Southmead Hospital in Bristol was amongst the first in the UK to start using the £1.4m robot in prostate cancer surgery and since then it has carried out 1,000 of the operations.

It has helped save hundreds of lives and, with greater precision and smaller incisions than is possible for a surgeon, has dramatically reduced recovery times for patients.

But this is just the beginning of robot-assisted surgery according to one of the surgeons who operates the urological robot.

David Gillatt, lead urological consultant at Southmead Hospital, said: "It [robotic technology] is changing the perception of things.

"A few years ago, you were a bit of a surgical hero if you did a really big operation, made large holes in people, and that was necessary then.

"But now we are thinking more in terms of being less invasive and how you do things in more a precise way and technology is giving us the ability to do that.

"We are starting to think about whether you can have almost autonomous little robots that you can put inside people that you can control from outside, external energy sources, bendy robots - what bendy instruments you can get into narrower places - targeting treatments onto tumours more precisely, you could go in all those directions and we probably will do."

1,000th prostate surgery

Bristol is said to be at the forefront this kind of research with the Bristol Robotics Laboratory, based at the University of the West England, looking at the application of robotics and working along with surgeons from Southmead Hospital.

"We are looking at where we are going to be in a few years time in terms of keeping on developing these technologies to make sure that we can do better things for patients," Mr Gillatt said.

"Safer surgery, quicker recovery, more precise surgery, all those issues - it's rather a long process of continuing change in innovation, with Bristol really at the forefront of it."

Since the Da Vinci robot first arrived at Southmead Hospital they have been able to dramatically improve outcomes for men with prostate cancer and reduced the length of stay for patients by more than half.

It has also been used to operate on other cancer patients, including constructing a new bladder inside a patient, which was a UK first.

In May, the robot at Southmead Hospital was used to carry out its 1,000th prostate operation.

Eric Dedman was the 1,000th prostate cancer patient to be operated on by the Southmead robot

Eric Dedman, 69, from Devon, was referred for robotic surgery at the hospital after living with prostate cancer for 14 years.

"It baffles me how the robot works but it is brilliant. If this technology was around when I was first diagnosed 14 years ago things could have been very different for me over that time," he said.

"Generally I'm doing well and I was home from hospital the day after surgery. I can't praise the team enough."

'Less trauma'

The robot is made up of a console operated by the surgeon, and a patient-side system with four robotic arms.

The surgeon operates controls on the console to manage the movements of surgical instruments inside the patient.

"It was pretty revolutionary at the time, you may have heard of laparoscopy, which is more like using chop sticks, so you move your hands around and it is two dimensional and quite rigid," Mr Gillatt said.

"Whereas with this, rather than just having rigid instruments, you have like little hands on the end of it that move around like your own hands.

"The surgeon sits at a console, a bit like an old fashioned games console, sort of like space invaders or something like that, and operates the instruments with his or her hands and feet from that console, so in theory, you could be doing it from a different country, or certainly a different room.

"Before it was old fashioned scalpel and incision type surgery. There would be more blood loss and more time to recover from those kinds of incisions and it was also more painful.

"But we can now use less pain control and it is quicker getting back to normal, out of bed the next day, doing stuff and getting home, so it has great advantages and less trauma to the patient."

On 8 September some of the 1,000 prostate cancer patients who have had robotic surgery at Southmead Hospital will take part in a 5km to raise money for prostate cancer research at the Bristol Urological Institute.

People can join the fun run by registering at www.runforthefuture.org.uk