How pioneering robotic surgery has cut recovery time

18 April 2023

This month, Isabelle Barker (Elective Recovery Lead) and Sotonye Tolofari (Consultant Urologist) talk us through how our Da Vinci XI Surgical Robot is helping reduce our patient’s length of stay in hospital. 

The Northern Care Alliance NHS Foundation Trust acquired the Da Vinci XI Surgical Robot in 2020. The robotic system is currently used to assist in keyhole procedures for Urological and Colorectal conditions including the treatment of, kidney and bladder cancers, colorectal cancers and reconstructive procedures for the urinary and gastrointestinal tract.

The Da Vinci Xi surgical system gives surgeons an advanced set of instruments to use in performing robotic assisted minimally invasive surgery. Surgeons perform surgery with Da Vinci systems by using instruments that they guide via a console (figure 1 click to enlarge).

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Figure 1 - Surgeons perform surgery with Da Vinci systems
by using instruments that they guide via a console

The system translates a surgeon’s hand movements at the console in real time, bending and rotating the instruments while performing the procedure. The tiny wristed instruments move like a human hand, but with a greater range of motion. The vision system also delivers highly magnified, 3D high-definition views of the surgical area. The instrument size makes it possible for surgeons to operate through one or a few small incisions.

The benefits of robotic-assisted surgery 

Da Vinci systems are used in a range of surgical specialities including urology, gynaecology, colorectal, thoracic and head and neck. There are more than 34,000 independent studies that suggest robotic-assisted surgery can offer patients demonstrated benefits compared with open surgery. These can include reduced blood loss; reduced risk of infection; fewer complication; reduced length of stay thanks to improved recovery time; and reduced chance of readmission.

Traditionally major open surgery involves a large incision into abdomen with a long hospital stay and higher risk of postoperative complications. More traditional keyhole ‘laparoscopic’ surgery involves smaller incisions into the abdomen for  surgical procedures however this modality does not allow for the intricacy that the robotic system provides due to the lack of wristed instruments. Robotic assisted surgery is a form of keyhole surgery that allows for more delicate and challenging surgery to be performed in a minimally invasive fashion in comparison to more conventional techniques.

We provide robotic assisted procedures to patients across Greater Manchester. This includes residents in Salford, Bolton, Wigan, Oldham, Rochdale and Bury.

One of the benefits of robotic assisted surgery is the ability to perform complex intra-abdominal operations with a relatively short recovery time.

The below photo (Figure 2 click to enlarge) demonstrates a patient undergoing a robotic nephroureterectomy at Salford Royal Hospital. This is an operation that involves the removal of the kidney and the tube that drains the kidney (the ureter). This is a treatment for kidney cancer. Traditionally, if this patient had an open operation, they would be in hospital for anywhere between 5-10 days. However, with the use of robotic surgery, this patient was discharged the following day to recover at home.

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Figure 2 - a patient undergoing a robotic nephroureterectomy at Salford Royal Hospital.

A further example of the short recovery times associated with robotic assisted surgery can be seen in the case of a 62-year-old man that recently underwent a robotic assisted cystoprastatectomy. This operation was required to treat an aggressive form of bladder and prostate cancer. This operation was undertaken in March on an otherwise fit and well patient. This man underwent a successful operation and was discharged from hospital 5 days later. Ultimately, should this operation have been undertaken in an open fashion the patient may well have stayed in hospital for ten days, which may have placed this patient at increased risk of post-operative complications.

Since the robotic system has been in use in the Northern Care Alliance, we have treated approximately 500 patients successfully for major intra-abdominal conditions affecting the urinary and gastrointestinal tract.

We plan to continue to use this innovative technology to provide the best possible service for our patients across Greater Manchester. 

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