UHNM celebrates 10-year urology robotics milestone

The Urology Department at University Hospitals of North Midlands NHS Trust (UHNM) are celebrating a decade of robotic surgery and thousands of patients benefitting from procedures on organs including kidneys, bladders and prostate glands. 

The robotic system, now in its second generation, allows surgeons at Royal Stoke University Hospital to perform complex keyhole operations with greater precision leading to less blood-loss during the procedure, less post-operative pain, a quicker recovery time and a shorter stay in hospital.

UHNM became only the second NHS Trust in the West Midlands to start performing urology procedures using robotics, following the delivery of its Intuitive Da Vinci Si system in July 2014.

Mr Lyndon Gommersall, Consultant Urologist at UHNM said: “In 2014 we were already really good at minimally invasive surgery, but carrying out procedures laparoscopically comes with its challenges. The introduction of robotic surgery has benefits for patient and surgeon, you have amazing light to see things, amazing 3D vision, and also wristed movement which you couldn’t do don’t have with keyhole surgery. Robotics marries these things together so you can do very accurate dissections and then reconstructions, for example joining the bladder back onto the water pipe or closing the kidney after the removal of a cancerous tumour.

“A real driver for change was our patient’s increased awareness of the benefits of robotics, and them requesting their treatment at other hospitals who were already offering it.

“Before we carried out our first robotic procedures, our surgeons completed 35 hours of simulation training, visited other robotic surgeons within the UK and attended the European Training Centre in Strasburg. When we were ready to start a new procedure, we had surgeons who were already performing robotics visit us to observe, so we could safely perform the first procedures on patients.

“The first cases on the robot were prostatectomies, the partial or complete removal of the prostate gland, followed by cystectomies, the removal of all or part of the bladder, then shortly after that partial nephrectomies, the removal of a tumour or diseased tissue from the kidney. We have since added more complex procedures to our caseload.”

UHNM currently has six robotic surgeons in its Urology department, plus colorectal and gynaecology surgeons, utilising the cutting-edge Intuitive Da Vinci Xi system, which replaced the Si system 2020.  

Mr Gommerall said: “Back in 2014 we might have done 80 prostate and 20 bladder removal operations in a year, now it’s over double that figure, up to 180 prostate removals and 50 bladders. Our department is now not only helping our own local population but surrounding areas including Shropshire, the West Midlands, and Mid-Wales. Being a big centre provides us with more experience and the ability to offer higher-risk operations on more complications complicated patients to the highest standards.” 

During an operation, the robotic system holds the instruments whilst the surgeon sits at a control console watching a magnified 3D view of the procedure.

It gives the surgeon a greater range of movement than the human wrist, meaning it is more precise and less invasive.

Over the past decade thousands of patients have benefitted from robotic surgery thanks to UHNM’s vision to invest in the latest technology. 

Mr Gommersall said: “UHNM has always supported us and gone along with our vision of robotic surgery, embracing it and moving it forward which is amazing. It’s an expensive technology, and other NHS Trusts have not always had the same support.

“Developing robotics relatively early in the region means we have been able to not only retain our surgeons, but also attract new people to come and work with us, and are able to train new surgeons and theatre staff in-house.”

A second robotic system at UHNM was funded by the Denise Coates Foundation as part of their support for the development of the Trust's cancer services which has been delivered via an £8.4 million grant to UHNM Charity.

Mr Gommersall said: “Robotics is the future, and there are many other specialities at UHNM lining up to do more robotics. I predict we’ll do more and more operations jointly with other specialities, for example, the joint removal of the bladder and bowel, and other complex procedures. 

“It’s about embracing new technology. Our surgeons currently have the skills to carry out laparoscopic and keyhole surgery, but I think the future generation of surgeons won’t have these and we will be the last to perform procedures these ways. Why learn to do things a number of ways, when you can learn to do it robotically and do it very well.”