A Bradford hospital robotic surgery team has marked another major milestone in its treatment of urological cancer.
The team of surgeons at Bradford Royal Infirmary (BRI), part of Bradford Teaching Hospitals NHS Foundation Trust (BTHFT), has recently completed its 1,000th prostatectomy (removal of the prostate) using its state-of-the-art da Vinci robot.
A year ago, the team passed the 1,000-case milestone for all robotic surgical procedures, making Bradford one of the highest volume robotic urological centres in the north.
The hardworking and dedicated urology team includes Consultant Urologists, Rohit Chahal, Raj Singh and Chidi Molokwu who were recently joined in delivering prostate cancer care by Consultant Uro-oncologist, Christos Gkikas and Robotic Surgical Assistant, Abigail Chambers.
Bradford’s relationship with robotic urological surgery began as far back as 2012, when the hospital took delivery of the revolutionary £2million da Vinci robot, partly funded by a generous £200,000 donation from the Sovereign Health Charitable Trust.
The da Vinci robot is an innovative machine which acts as an extension of the surgeon’s hands and fingers in miniature and enables advanced keyhole procedures which help eliminate potential human problems such as hand tremor.
Mr Chahal said: “Over the last six years the practice has advanced significantly. We initially started with robotic prostatectomies (removal of the prostate gland) and gradually offered robotics for the benefit of patients undergoing partial nephrectomy (removal of a kidney), radical cystoprostatectomy (removal of the bladder and prostate gland) and most recently nephro-ureterectomy (a minimally invasive surgical procedure to remove a patient’s renal pelvis, kidney, ureter, and bladder cuff.)
“In the last two years no open surgery has been performed in Bradford for any of these procedures. In the past year, the team operated on 265 cases which represented a 25% increase in number of cases undergoing robotic prostatectomy.”
He added that there were “significant” benefits of robotic prostatectomy to the patient over open radical prostatectomy.
“The majority of patients are discharged the following day as compared to three to four days with the open procedure. Functional results with continence and sexual function recovery are superior due to the enhanced 3D vision the robotic surgery provides along with the fine instruments allowing improved dexterity to achieve these results.
“Cancer outcomes are at least equivalent and in our opinion probably superior as well. With significant experience with this technique at BTHFT we have expanded the indications to much higher risk and locally advanced patient groups previously not offered surgery.
“At BTHFT it is all about team work across our departments to support these patients. This begins in clinic with the cancer nurse specialists and the theatre team to ensure patients are provided the highest standard of care. The Trust’s radiologist team along with our consultant histopathologists ensure that the progress of patients from referral to treatment is achieved in a timely fashion despite the increasing referral rates.
“Finally, staff on our urology ward (Ward 14 at BRI) provide excellent post-surgery care for our patients.”
Since installation of the da Vinci robot, the team has ensured regular updates and refinements of their techniques thanks to visits from several international experts from Germany, Belgium and Sweden as well as from University College London and Guy’s Hospital, London to help incorporate the highest standards into practice.
The da Vinci team has also collaborated with all the Northern cancer centres to establish the NERUS meeting, so far organising three live surgery updates on robotics. BTHFT will once again be hosting the fourth meeting in November 2019.
The Bradford robotic surgeons have also provided mentorship and support to nearby cancer centres establishing robotic surgery.
The 1000th prostatectomy patient is Mike Jaggar, who underwent surgery in March this year, after discovering he had prostate cancer purely by chance.
Mr Jaggar, 53, said: “My next door neighbour was restoring an old Morris Minor car and I was helping him. He was a member of a Morris Minor owners’ club and asked me to go along to a meeting, where the speaker happened to be from Prostate Cancer UK. He spoke about the importance of getting a PSA test (a blood test to help detect prostate cancer.)
“My neighbour went along to his GP and then each time he saw me, kept asking if I’d done the same. Eventually I went along and it was a huge shock to discover I had cancer. I’d had no symptoms and felt completely well. I look back now and think going along to that meeting must have been fate.
“I feel indebted to the NHS for the treatment and care I’ve received and especially to Mr Singh and his team and the staff on Ward 14 at BRI. I would now urge any man to go along and be tested because it’s best to find out as soon as possible and then something can be done. I feel like I’ve been given a second chance.”
The very first patient to undergo robotic-assisted surgery was Mike Watson, of Skipton, who had his prostate removed in July 2012 at BRI using the da Vinci robot.
Mr Watson said: “I was enthusiastic about robot surgery as I had done my research and learnt that the recovery time would be much quicker and that the actual incisions would be so much smaller than conventional surgery.
“I have never looked back since having the surgery. My health is excellent and I usually do a 5 km ‘park run’ now three times a week. Congratulations to the team on their 1000th patient.”
Extra information re the da Vinci robot
It is named after Leonardo da Vinci, who put forward the idea of a robot in 1495, and has seen its technology developed by the NASA space programme.
It allows for high precision surgery where the robot is docked onto the patient. The operation is then carried out with the help of four robotic arms that are inserted into the patient’s body through tiny incisions.
During a procedure, the consultant sits at the robot’s computer console, which offers a clear 3D close up view of the patient’s organs, nerves, blood vessels and muscles.
Bradford Teaching Hospitals became only the second centre in the region to obtain a £2m revolutionary “surgical robot” to perform critical operations on its patients.
The Da Vinci robot enables advanced keyhole procedures which help surgeons eliminate potential human problems, such as hand tremor, as the massive bulk of the robot allows its arms to manoeuvre better than the human hand in open surgery.
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Note to Editors
Bradford Teaching Hospitals NHS Foundation Trust:
Bradford Teaching Hospitals NHS Foundation Trust is responsible for providing hospital services for the people of Bradford and communities across Yorkshire. We serve a core population of around 500,000 and provide specialist services for 1.1 million people.
Our 5,500 staff work over several sites, including Bradford Royal Infirmary, which provides the majority of inpatient services, and St Luke’s Hospital, which predominantly provides outpatient and rehabilitation services. We also manage local community hospitals at Westwood Park, Westbourne Green, and Eccleshill.
In early 2017, a new £28 million wing opened at Bradford Royal Infirmary, part of a £75m investment to improve patient care across our hospitals over a five-year period. It provides world-class facilities for elderly care, children’s services, a state-of-the-art intensive care unit with increased single-room provision and a retail concourse.
The new wing is a continuation of our work to improve patient experience after our new £2 million neonatal unit officially opened in January 2015. Our maternity services were recently shortlisted for the Royal College of Midwives’ (RCM) Midwifery Service of the Year Award, recognising excellence and innovation in the provision of maternity care.
In 2017, we also completed a £2m refurbishment of our Emergency Department (ED) as part of an ambitious vision to create a more efficient acute medicine service for the people of Bradford. It has been designed to provide a slicker and more efficient service, with faster senior clinical involvement at an early stage in the patient pathway.
As a teaching hospital, we are at the forefront of education and development in healthcare, and have an excellent reputation for research performance. We are one of the leading centres in conducting applied research in the country, particularly in quality and safety, elderly care and rehabilitation.
The Trust is home to the Bradford Institute for Health Research (BIHR) where researchers have led the development, validation and implementation of the award-winning Bradford Electronic Frailty Index (eFI) which helps calculate an elderly person’s risk of disability, impairment, falls and complications of chronic diseases, as well as their diminishing independence and capability. This is now being used by 98% of all GPs across the country.
Our award-winning Ophthalmology department is home to numerous worldwide clinical trials taking the lead in eye care research and we are one of only three sites in the United Kingdom to be enlisted in the Perioperative Enhanced Recovery Hip Fracture Care of Patients with Dementia (PERFECTED) study, which will investigate how the NHS can introduce better standards of care to improve outcomes for people with dementia.
The Trust has its own Bradford Hospitals Charity: www.bradfordhospitals.nhs.uk/charity
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For more information please visit www.bradfordhospitals.nhs.uk