A robot and three teams of surgeons worked simultaneously on a single patient to perform a presumed first cancer surgery, cutting recovery time by a third.
The amazing procedure, which involved 14 surgeons, was performed in July on a married father of one with advanced rectal cancer.
The experts behind it hope that the breakthrough will open the doors for further operations involving more than one surgeon at the same time.
Every year about 43,000 Britons are diagnosed with colon cancer. Most cases occur in the rectum.
Symptoms include changes in bowel movements and bleeding, and more than 50 percent of cases are diagnosed at a late stage, when extensive surgery may be required.
The amazing procedure, which involved 14 surgeons, was performed in July on a married father of one with advanced rectal cancer. Pictured: An illustration of the procedure
An example of the type of surgery that may be required is pelvic augmentation, which removes the organs in the pelvic area, including the bladder, rectum, prostate, and part of the kidney to stop the disease from spreading.
It requires the expertise of at least three surgical teams, and the patient is left with colostomy and urine bags for life.
Until now, we worked in shifts. One team follows the other, first a bowel doctor, followed by a prostate specialist and finally plastic surgeons to repair the damage.
But doctors at Norfolk and Norwich University Hospital made the decision to run all three stages simultaneously with a £ 1 million Da Vinci Si robot.
The procedure took less than ten hours, compared to the 12 hours it takes to do step-by-step.
But the biggest success of the operation was the recovery time. Pelvic enlargement patients typically spend three weeks in the hospital – this patient was there for only seven days.
Colorectal surgeon Irshad Shaikh said the idea started out as “just a thought,” but quickly turned into a concrete plan as he discussed the potential benefits with his colleagues.
The experts behind it hope that the breakthrough will open the doors for further operations involving more than one surgeon at the same time. Picture: stock picture
He says, “Pelvic extenterations are extremely traumatic because so much tissue has to be removed. By working together, we realized that we could make the procedure less invasive and thus significantly reduce tissue trauma and blood loss. ‘
The patient, Peter Fabb, 53, from Heveningham, Suffolk, is believed to be the first person in the world to have surgery in this way. He was relieved to get out of hospital so quickly and is now recovering at his family home.
He said, “I’m still getting up, but recently I went for a mile walk with the dog, which felt like an achievement.”
Peter was diagnosed with colon cancer in November after discomfort and lower back cramps while driving.
As a beer delivery driver, he started to feel uncomfortable sitting in his truck doing his rounds.
He was first given antibiotics because his doctor thought he had an inflammation of the prostate, but when the pain didn’t go away, he went for a scan and it found that cancer had spread from his rectum to his prostate.
He was recommended for surgery after chemotherapy had not had the desired effect.
Mr. Shaikh felt he would be the perfect candidate to try out the new ‘tandem’ pelvic augmentation.
In the past, pelvic extensions were open surgery, in which the pelvic area was cut open. Mr Shaikh and prostate surgeon Omar Al Kadhi performed the procedure through keyhole incisions with the helping hands of the Da Vinci Si.
Surgical instruments are attached to the robot’s four arms, each of which has fully rotating wrists. The arms are controlled by the surgeon, seated at a console with two joysticks and a 3D screen.
In the weeks before, the Norfolk and Norwich teams held a dress rehearsal – charting everyone’s positions in the theater.
Peter arrived the morning of the procedure and was in the operating room under general anesthesia less than an hour later. During the ten-hour operation, Mr. Sheikh and Mr. Al Kadhi take turns operating the robot.
First, the colon and most of the rectum were removed, followed by the bladder and prostate.
At the same time, plastic surgeons Anais Rosich-Medina and Richard Haywood took muscles from Peter’s inner thighs, which were transplanted into the pelvis to provide support after the organs were removed.
Finally, Peter’s colostomy and urine pouches were attached, through stomas (ports) in his mid-abdomen.
Mr. Shaikh said the team had to be careful with the robot’s arms, which are capable of knocking people over, but said the operation went very smoothly thanks to “fantastic teamwork.”
When he got home seven days later, Peter says he was surprised at how small the scars were given the scope of the procedure – and he’s now cancer-free.