Robotic surgery has been commercially available for more than two decades, yet for many patients it can still seem out of reach. In a feature by Tania Jacobs, The London Clinic described where the technology stands today and why its future is closer than many people think. This article summarises the main points on robotic surgery at The London Clinic, including Professor Prokar Dasgupta's explanation of how it has changed prostate cancer surgery.
A pioneer in private robotic surgery
The London Clinic was the first private hospital in the UK to introduce robotic surgery, in 2005. It has since built a centre of excellence in robotics on Harley Street. At the time of the feature, it was the only UK independent hospital with four different robots: the da Vinci Xi for soft tissue surgery, Navio for orthopaedics, AquaBeam for prostate resection and ExcelsiusGPS for spinal surgery. Our page on Aquablation therapy explains how the AquaBeam system is used for an enlarged prostate.
A charitable hospital
The London Clinic has been a charity since 1935. It has no shareholders, and surplus income is reinvested in patient care, education and training, and research and innovation.
Professor Dasgupta, a Consultant Urologist and the hospital's Robotics and Technology Lead, explained that the hospital has always looked for the best ways to care for patients and improve outcomes, and to share good practice beyond its own walls.
A team approach
The London Clinic Centre for Robotic Surgery brings together consultants, nurses, anaesthetists, surgical assistants and other specialists who work closely as one team. This allows the centre to be quick, knowledgeable and adaptable. Our article on the MedithinQ headset describes how the team supports the surgeon during an operation.
How robotic prostate surgery works
Professor Dasgupta explained the change in simple terms. Twenty years earlier, removing a prostate containing cancer meant a cut in the abdomen. Today, the operation is carried out through six small keyhole incisions, with the patient connected to a robot whose instrument wrists are only 7 millimetres wide.
The robot provides 3D high-definition vision, magnified at least ten times. The prostate, roughly the size of a chestnut, appears as large as a football, so the surgeon can see it much more clearly. The system also removes tremor, making the surgery very precise. Patients lose less blood, stay in hospital for a shorter time and recover more quickly. Our robotic prostatectomy page describes the operation in more detail.
Benefits across specialties
Mr Manish Chand, a Consultant Colorectal Surgeon and Professor of Surgery at The London Clinic, noted that robotic surgery is minimally invasive, which greatly reduces pain, scarring and recovery time.
In prostate cancer surgery, around 94% of operations were robotic at the time of the feature, compared with just 1% twenty years earlier. Uptake has been slower in other areas, partly because of limited resources and training, but The London Clinic is extending its approach to colorectal surgery and other specialties.
Training the next generation
Part of the centre's role is to close the skills gap. It provides education and training so that surgeons can learn to use robotic technology safely and confidently. The Royal College of Surgeons of England sets standards for surgical training across the UK.
Still in its infancy
Despite the excitement, Professor Dasgupta pointed out that robotic surgery probably accounts for less than 10% of surgery worldwide. In terms of scale and awareness, it is still at an early stage. He believes independent hospitals have a responsibility to help make it more widely available, so that patients know they have options and that robotics may often be the better choice.
More information about the hospital is available from The London Clinic. Our news page collects other features on Professor Dasgupta's work.
To discuss whether robotic surgery could help you, please contact the clinic.