Surgeons at Nottingham University Hospitals NHS Trust have performed their first cystectomy on a patient with cancer of the bladder using a robot.
The operation to remove the 67-year-old woman’s bladder was led by Consultant Urology Surgeon Mr Will Green (pictured with the robotic equipment), and Consultant Mr Phil Goodall.
They were mentored by Mr Vivek Kumar, from Norfolk and Norwich University Hospitals, who has extensive experience in robotic surgery.
The rest of the team included Dr Oliver Griffiths, Consultant Anaesthetist, and robotic surgical assistants Sarah Wells and Kellie Foster. The procedure involved the surgeon guiding the arms of the Da Vinci robot remotely, to perform this delicate keyhole surgery on the patient, who lives in Mansfield.
Cystectomies are performed as an option for patients where their bladder cancer has become invasive and will not respond to less invasive treatments such as local resections (the removal of cancerous tissue) or bladder immunotherapy (drug treatments).
The Da Vinci Robot, which is based within the Urology Department at Nottingham City Hospital, has been used in prostate surgery at Nottingham for at least eight years. But as well as making better use of NHS resources, there are other benefits to robotic surgery.
“Use of the robot means less blood loss for our patients while they are on the operating table and it enables the surgeon to perform more complex procedures,” said Will Green.
“It’s easier to see the nerves inside the patient and avoid them using this technology; it also creates a smaller wound. Sparing the nerves that run over the prostate may mean that more men who undergo this surgery using the robot may be able to maintain erectile function, something particularly important in younger patients.
“As well as dealing with the bladder cancer, the other big benefit for the patient is they typically make a faster recovery, from seven to eight days in hospital down to five days post robotic operation.”
Mr Green added: “We’re excited to be introducing this high-tech and innovative surgery for Nottingham. Once we gain more experience in this robotic procedure in our theatres, the intention is that our patients won’t need a HDU (High Dependency Unit) bed in which to recover, which would free up that HDU bed for another patient.”
In the next year or so, the urology surgical team aim to offer robotic ‘neobladder’ surgery to selected patients. In this procedure, surgeons will create a new bladder out of the small bowel, to prevent the need for patients to use a urostomy (a stoma bag for urine worn on the abdomen).
