Mum, my surgeon is a robot!

Our author, Marcela Leite, went to the Guardian Live Robot Surgery at the Science Museum – and no, it doesn’t involve a robot being cut open

When I first received an invite to the “Live Robot Surgery” event, I thought the hosts were going to pull apart a robot to show its mechanics. Once I understood this was actually a medical operation assisted by a robot (mind you, not solely performed by one!), I was simultaneously relieved and amused to read on the event listing that a surgical mannequin rather than a live patient would be used. So on a pleasant Friday evening, I set out to witness the re-enactment of the first robotics assisted operation performed in the UK, which originally took place in September 2001 at St Mary’s Hospital here in London. It was hard to believe the organs were not real as the surgical team operated on the mannequin to remove its gall bladder. The panel discussion, as is often the case, was as interesting as the scientific demonstration. A remarkable evening, by all means.

The event, which was chaired by our very own Imperial College science engagement guru, Professor Roger Kneebone, is one of the highlights of the ongoing programme around the Robots exhibition, which is open at the Science Museum until September. The procedure was performed by the same team as in 2001: surgeon Lord Professor Ara Darz and nurse Shirley Martin. The original robot, named “da Vinci” after the company which still dominates the medical robotics sector, was also used at the event. However, it has now been retired into the Museum’s collection after a fruitful career which saw it perform many feats, including participation in a 007 film.

Prof Darz and Prof Kneebone explain the da Vinci robot to the public

After a brief introduction, the doctor sat, head nestled against the machine and eyes fixed onto the screens, with his back to the operating room. With awe, the packed audience watched as Lord Darz manipulated a handheld console, which translated hand movements into very delicate and accurate actions by the tweezer-like mechanical hands inside the patient’s abdomen.

Prof Darz and the da Vinci robot skilfully cut the membranes connecting the gall bladder to the liver. While the consoles transmit information from the hands to the robotic arms, the pedals control the cameras

While the gall bladder was skilfully cut free, membrane by membrane, Shirley was at hand to help the final stage and remove the organ with a device humorously compared to an old-fashioned condom. Another nurse monitored the patient’s vital signs throughout the procedure – should a blood vessel be cut by mistake and haemorrhage occur, the patient would very quickly need to be operated on to stop the bleeding. With the doctor positioned on the other side of the room, the pressure is on the nurse.

Above, Shirley with the ‘old fashioned condom bag’ used to collect the organ, and below, she helps with scissors

Although there is obvious loss of tactile feedback, surgeons are trained to feel through the console and the delicate robotic tools are more precise than human hands if skilfully operated. Like an Edward Scissorhands turned scientist. Comparing his practice to art, Lord Darz still recalls the shocked face of that first patient to whom he communicated his plan to operate with the assistance of a robot.

Despite patients still feeling initial unease about robot assisted operations, most are convinced that these are better than traditional open surgeries. Surgeons now see through large screens with much deeper sight than with previous magnifying goggles, and 3D imagery in particular is revolutionising cancer surgery. And while twenty years ago patients would be in hospital for about a week and suffer a major incision to have their gall bladder removed, with the robot assisted surgery, the patient can be operated on in the morning and be home for dinner on the same day.

When Lord Darz had to rush off after answering some questions from the public, Shirley and Prof Kneebone were joined by Sir John Wickham, the ‘godfather’ of urological robotic surgery in the UK, and by Mr Erik Myers, a younger urologist who has used robotics since the start of his career. These techniques are now part of the medical school curriculum.

The panel discuss their involvement with robotics in medicine

The panel reviewed their experiences and the development of robotics in the UK in the past decades: Sir Wickham pioneered keyhole surgery (so called due to the small incision needed to operate on the patient) and hasn’t looked back; Erik experienced robotics before open surgery, and sees surgical medicine becoming much more integrated with advanced scanners driving the changes. Shirley remains in Lord Darz team and joked that she has gone from nurse to technician, and has had engineers on the speakerphone during surgery.

While most questions were asked by practicing medical professionals, the audience included children and others simply interested in the opportunity to witness what most people could hardly imagine. Interestingly, when asked whether we are heading towards robot doctors, Lord Darz was confident that the advancements will more likely be towards home support for the ageing population. I can’t wait to visit the Robots exhibition and learn more about what the future might bring!

Marcela Leite is studying for an MSc in Science Communication

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