Robotic-assisted surgery at Guy's Hospital

 

Guy's and St Thomas' has pioneered the use of robotic technology in the UK. We are now an advanced training centre and are internationally renowned for our robotic-assisted urological surgery.

What is robotic-assisted surgery?

See our laparoscopic and robotic procedures page for information on what robotic-assisted surgery is, its advantages over other types of surgery and the procedures we perform.

The da Vinci robotic system

Da Vinci robot being used in theatre

We installed a da Vinci robot in 2004 thanks to a grant from Guy's and St Thomas' Charity. From the success of our robotic surgery programme and the increase in demand from patients, in January 2011 we upgraded to the latest model. This is the Da Vinci Si HD dual console system, featuring 4 robotic arms and a double operating console. This advanced robot allows surgeons to:

  • control instruments while sitting at a special console away from the patient's side
  • view details extremely closely (at up to ten times the magnification) and at a high resolution because of its unique 3 dimensional (3D) vision system
  • move instruments in many different directions (degrees of freedom), due to EndowristTM technology. This improves the surgeon's dexterity and makes the surgery and in particular suturing, much easier compared to laparoscopic surgery.

The new robot has 4 arms rather than the previous model's 3 arms and allows 2 surgeons to operate at the same time (dual console). Its longer arms allow surgery on larger patients and means we can offer a wider range of surgery. It has a larger range of specialist instruments, including 8 and 5mm tools, is lighter and more manoeuvrable. MRI and CT images can also be shown to the surgeon while operating, while enhanced HD vision helps the surgeon as it effectively doubles the resolution.

Because the surgeon is seated in a comfortable position, it has been claimed that robotic-assisted surgery is more ergonomic (user-friendly). We are investigating this in our 'motion laboratory' as part of our research into surgical fatigue (tiredness).

The da Vinci robot is also regularly used by the gynaecology team and the ear, nose and throat and maxillofacial departments are currently developing their programmes.

Read more about the da Vinci robot on the Intuitive surgical website.

Da Vinci SI dual console

Short clip showing the new robot being calibrated before first use.

Staff involved in robotic-assisted surgery

We are proud to have one of a small number of UK urology professors in our department, Professor Prokar Dasgupta, who developed our entire robotic programme. Robotic-assisted surgery has become a standard approach in our department and as well as Professor Dasgupta, it is currently carried out by:

Many of the team are involved in robotic mentoring and training in other centres as well as teaching our own senior urology fellows and specialist registrars.

Future directions and research

We are working closely with mechanical and robotic engineering colleagues in the Academic Health Sciences Centre to improve patient outcomes after robotic surgery. We are exploring:

  • MRI based pre-operative planning (planning before surgery) and intra-operative direction (during the operation), allowing the surgeon to switch between the real view and the MRI scan during the operation to help identify structures quickly and precisely.
  • enhanced sensation for the surgeon via a keyhole (laparoscopic) device to scan tissues during the operation. This gives valuable and immediate information to the surgeon to improve cancer localisation.