Since the first Robotic-assisted Surgery (RAS) was carried out at Raigmore Hospital in August last year the programme has gone from strength to strength with three surgical specialities now up and running.
NHS Highland took delivery of the DaVinci Xi robotic system, produced by Intuitive Surgical, in 2021 bringing the health board to the forefront of surgical delivery. Robotic surgery, using articulated 'keyhole' instruments controlled remotely by the surgeon from a console next to the operating table, allows complex surgical procedures to be performed in a minimally invasive manner. As a consequence, patients require smaller incisions, tend to have less post-operative pain and recover quicker.
Since August there has now been almost 100 RAS procedures carried out in NHS Highland. Initially starting in the Colorectal Unit, the programme has now been expanded to both Gynaecological and Urological surgery.
Early results are encouraging and show that patients undergoing major bowel cancer surgery are spending significantly less time in hospital. For patients undergoing open surgery, the average length of hospital stay was eight days and this has now reduced to four days following RAS surgery. Far fewer patients also require critical care following surgery with high dependency unit (HDU) admissions dropping from 70% to less than 10%.
Following substantial investment from both the Scottish Government and individual health boards, the use of surgical robots has increased significantly in Scotland since 2020 and it is hoped that the type of benefits already being seen in Highland will be mirrored across the country.
Priorities for the first phase of this national rollout are procedures where there are likely to be the greatest benefits for patients such as operations for colorectal, gynaecological and urological cancers. The second phase will expand RAS use to other surgical specialties, including patients with complex benign conditions.
Colin Richards, Colorectal Consultant at Raigmore Hospital, led the team who carried out the first of these operations last year and is delighted with progress so far.
He said: "Investing in robotics means that patients in NHS Highland now have access to world-class surgical technology and we have already shown that this is making a real and measurable difference to patient outcomes."
“Having used the system for the last six months, I would describe it as nothing short of transformative - we are able to perform surgery that is less invasive than ever before but with a level of precision that I never thought possible."
"Going forward, we are working with colleagues across the country to expand the scope of robotic surgery and in the future hope more and more of our patients will benefit."
Clive Hunston, 65, was a patient in Raigmore Hospital last month where he underwent a robotic left hemicolectomy to remove part of his large intestine due to bowel cancer. Having not spent a lot of time in hospital prior to this he wasn’t sure what to expect but is pleased with how it went.
He said: “I wasn’t sure what to expect so being told it would be robotic surgery didn’t really affect how I felt about coming in for surgery.
“When you consider what I had done I was in quite good shape afterwards. I didn’t require high dependency and was only in hospital for four days. There is minimal scarring and I seem to be back to normal now.
“It’s a technological marvel what they can do. I think if anyone is feeling apprehensive about it I hope I can reassure them that it is nothing to be anxious about.”
Mr Hunston, who lives in Caithness, is keen to point out that routine bowel screening is how his cancer was picked up.
He said: “I always do my screening when I get the reminder through the post so thought nothing of doing it this time around. I had no symptoms at all and felt absolutely fine. I had no idea I had a tumour.
“It shows just how important screening is and, even if you have had negative tests in the past and you feel fine, please don’t get complacent and do your screening when you are asked to.”