This month, Mr Al-Lami and I finally made it to Belgium to complete our robotics training, despite the COVID-19 restrictions. It was our third attempt. The first was abandoned due to the alpha variant and the second was cancelled due to on-going restrictions. The journey was stressful and we had to fly via Amsterdam due to the reduced flight schedules in operation. There were a number of checks in order to get on the plane but once we knew the system things went much more smoothly; except for the change in the rules which the Belgium government introduced on our first day without any warning. However this did not affect the course or trip but colleagues in London have had to abandon their trip scheduled for next month.
The course was held at the ORSI academy in Gent and was sponsored by Intuitive who make the Da Vinci robot. It was a two day lab-based course learning how to use the robot for transoral cancer surgery. There were some ENT consultants from Denmark who are using the robot for obstructive sleep apnoea so we are planning a visit to see them and their set up later this year.
Following a short periodof isolation and a week of telephone clinics, we have undertaken our first two robotics lists under the proctorship of consultant colleagues from London and our first solo procedures are booked inJuly. The pioneering surgery was covered by Kent Online – read here for more information: https://www.kentonline.co.uk/folkestone/news/man-receives-operation-from-1-5m-robot-250093/
Minimally invasive transoral surgery uses a medical robot controlled by a consultant surgeon to perform the procedure rather than the surgeon operating directly on the patient. The robot reduces the need for major surgery which would require the surgeons to split the jaw to remove the tumour (although sometimes this is still necessary). There are no external incisions and therefore no scarring from the procedure to the throat. Robotic surgery focuses on the exact site of the cancer rather than the surrounding area which means patients recover faster with shorter hospital stay and have better swallowing outcomes than traditional open surgery.
Following robotic surgery, patients may not require further treatment with chemotherapy or radiotherapy and this can potentially reduce subsequent side effects and toxicity from oncological treatments as well as potentially improving functional outcomes of patients with head and neck cancer. We are investigating this in the clinical trial PATHOS which will hopefully be up and running in the next few weeks. East Kent Hospitals University NHS Foundation Trust is the only unit in Kent currently offering a head and neck robotic service.