New robotic technology gives surgeons a ‘sense of touch’ in UK first

Revolutionary robotic-assisted technology that gives surgeons a ‘sense of touch’ as they operate with robotic instruments has been used at St Thomas’ Hospital in a UK first.

The newly-approved surgical instruments, which have what is known as ‘Force Feedback’ technology, are now being used with the hospital’s da Vinci 5 robotic system for colorectal, gynaecological and upper gastrointestinal surgeries.

The new instruments allow surgeons, for the first time, to feel the pressure they are exerting as they push and pull on a patient’s tissue during robotic-assisted surgery. Previously, they have been reliant on vision via their immersive console to see what is happening as they guide the robotic system’s surgical instruments inside a patient’s body – now, they can feel it through their hands too.

It is hoped this technology will enable gentler surgery and improve outcomes for patients, with a growing body of evidence from the United States reporting promising early results.

Professor James Gossage, consultant upper gastrointestinal surgeon at Guy’s and St Thomas’, performed the first surgeries with the new Force Feedback instruments on 13 October.

He said: “Robotic-assisted surgery has already transformed levels of precision and faster recovery times for patients, but the biggest limitation has been the lack of ‘feedback’ you get from the patient’s tissue as you are operating.

“With the new Force Feedback instruments, we can now feel a sense of resistance within the hand controls on the console, so we get a better sense of whether we are exerting the right level of pressure on tissue as we operate.

“This offers an even higher level of precision, which reduces trauma to the patient’s tissue. That means less bruising and inflammation, and it helps improve overall recovery and outcomes from the surgery.”

Guy’s and St Thomas’ NHS Foundation Trust now has a fleet of 13 surgical robots and 3 diagnostic robots across its 5 hospitals, making it the largest centre for robotic-assisted surgery in the UK and one of the largest in Europe.

The Trust’s surgical team began operating on patients using the da Vinci 5 in early April at St Thomas’, and another da Vinci 5 has more recently been added at Harefield Hospital. However, the robotic-assisted system at St Thomas’ is the first in the country to use the Force Feedback instruments provided by its manufacturer, Intuitive.

Guy’s and St Thomas’ clinical director for general surgery, Alexis Schizas, said the da Vinci 5 robot’s new Force Feedback features were the latest in a long line of advancements in robotic surgery at the Trust, ensuring patients can access all the benefits of this new technology.

He said: “For many years now we have increasingly been using robots to perform a wide range of procedures that would have previously been done either by open or ‘keyhole’ surgery.

“This type of robotic-assisted surgery is far less invasive, which results in less pain and blood loss and faster recovery times. This usually allows patients to go home much sooner after their operation – for example, our colorectal patients undergoing some of the most complex surgeries go home about 4 days sooner on average than they would after open surgery.”

The Trust’s fleet of robotic-assisted surgical systems also helps improve surgeons’ efficiency, as the control consoles are ergonomically designed to be more comfortable to use for extended periods of time, compared with operating directly on a patient. This means they can perform more operations each day without feeling tired.

The Trust is committed to working with a range of different suppliers within its robotic surgery programme. Its fleet of 13 robotic-assisted surgical systems includes 9 da Vinci systems, 2 Hugo systems, a Velus orthopaedic knee surgery system, and a Versius system at Evelina London Children’s Hospital.

Nicholas Kokkinos, 57, from Bromley was the first patient to receive surgery using the new Force Feedback technology on 13 October. Speaking after his hiatus hernia repair operation, he said he was looking forward to getting back to normal life, including eating at his favourite restaurants again.

He said: “Before my operation, going out to a restaurant was practically impossible. I had to follow an extremely restricted diet, with very few types of food I could comfortably eat. I’m now looking forward to getting that part of my life back.

“What has particularly surprised me is how quickly I’ve started recovering. Just a day after surgery, I can already get up and move around much more easily, and my incision pain has reduced significantly, becoming barely noticeable.

“I’m delighted to have been among the first patients to experience this new robotic technology with Force Feedback.”

More than 17,000 patients have already benefitted from robotic-assisted surgery at Guy’s and St Thomas’, and almost all prostate, kidney and lung cancer surgery is now completed robotically at the Trust.