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State-of-the-art robots to enhance Oxford cancer care

20/04/2021

Oxford University Hospitals NHS Foundation Trust has purchased two new surgical robots that will greatly enhance the treatment that can be offered to patients, especially those with cancer.

The da Vinci X and Xi surgical systems, distributed by the Oxford-based company Intuitive, will be located at the Oxford Cancer and Haematology Centre at the Churchill Hospital. They will replace OUH's current da Vinci Si surgical system, which the Trust acquired in 2009.

The systems allow surgeons to perform complex keyhole operations remotely with greater precision. This leads to less blood-loss during the procedure, less post-operative pain, a quicker recovery time and a shorter stay in hospital.

The robotic-assisted system provides the surgeon with a magnified 3D view of the operative fields, and the robotic arms allow for enhanced manual dexterity. The surgeon sits at a console and controls the robotic arms that manipulate and cut tissues in the patient. A second console allows a trainer to supervise a surgeon who is gaining experience in performing this procedure.

The current da Vinci Si robotic system is used predominantly for surgery of the prostate, kidney and colon; in 2019, more than 200 urological procedures, in particular radical prostatectomies, were carried out using this system. Having more advanced features on the new surgical systems and two robotic theatres in operation at the same time will allow clinicians to treat more patients using the robots and to extend their use to more complex cancer operations. 

The da Vinci X system will be a direct replacement for the Si system, while the da Vinci Xi is a more advanced system that includes features such as a 'smart' operating table, which moves with the robot, reducing  the time between steps and so shortening the duration of the procedure.

Professor Chris Cunningham, Director of OUH's Surgery, Women's and Oncology Division, and a colorectal surgeon, said: "When the Trust acquired the da Vinci Si robotic surgical system in 2009, it placed us at the cutting edge of cancer care. We are excited to receive these new systems, which will allow us to carry out keyhole procedures that were not previously possible, and to continue to deliver the best possible care for our patients.

"The clinical benefits of the kind of precision surgery that robotic systems offer are now well understood: reduced tissue trauma, blood-loss and complications such as infections and pain. This translates to quicker recovery times, reduced length of post-operative stay in hospital and fewer readmissions. All of this is great news for our patients."

The da Vinci Xi system was delivered to the Churchill Hospital in late March 2021 and was used to operate on its first patient on 19 April. The da Vinci X system will begin to be used from June 2021, until when the da Vinci Si will continue to be used alongside the Xi system. During this period, more OUH surgeons will be trained on the new system by experienced surgeon mentors.

As well as being able to expand the lower gastrointestinal surgery they can perform, the Trust's surgeons will also be able to use the robotic-assisted systems to conduct upper gastrointestinal surgery, such as oesophagectomies; hepatobiliary surgery, principally the liver and pancreas; and  head and neck surgery. The ability to perform more complex head and neck procedures will save many patients having to undergo chemotherapy. The Trust also hopes to expand the use of surgical robots to other specialties in due course.

Prof Meghana Pandit, OUH's Chief Medical Officer, said: "We are delighted to be able to extend the Trust's robotic programme, so that we can not only expand urological services, but also apply it to new specialties and new surgical procedures, for the benefit of our patients. This new technology will play a major role in future-proofing the Trust's status as a major cancer centre."

David Marante, Regional Director at Intuitive, the makers of the da Vinci robotic-assisted surgical systems, said: "Oxford is renowned for medical and scientific innovation and we are proud to expand our collaboration with the NHS here in the community where we have our UK headquarters, as we strive to advance minimally invasive surgery, improve patient outcomes, and lower the total cost of care."

Photo: Surgical Care Practitioner Prue Barry and Professor Chris Cunningham, Director of OUH's Surgery, Women's and Oncology Division with the new daVinci Xi robot