A NEW era in surgery has begun in Oxford with surgeons using a four-armed robot to perform operations on cancer patients.

A £2m robotic surgery system has been installed in an operating theatre at Oxford’s new cancer centre and is set to benefit patients undergoing keyhole surgery to remove certain types of cancer.

The technology involves a set of four robotic arms being controlled remotely by surgeons, sitting away from the patient at two consoles, from where they can remove organs through keyholes and undertake other surgical procedures.

The robotic arms are far more precise than the hands of even the most experienced surgeon. And surgery is less invasive, resulting in less blood loss. Patients recover more quickly from robotic surgery than the equivalent conventional surgery, allowing them to go home earlier.

Patients undergoing surgery for prostate cancer, for example, can expect their length of time in hospital to be cut from five days to 24 hours, substantially cutting costs in the long term.

The new instrument will initially be used in some prostate and renal cancer operations, with surgeons aiming to expand its use to bladder and colorectal cancers and gynaelogical surgery.

It is believed to be the first time a robotic surgery system has been employed in Oxford. It has already been used for five operations, supervised so far by experts from outside Oxford.

A training and development programme in the use of the technology is under way for surgeons at the Oxford Cancer Centre, on the Churchill Hospital site.

While robotic systems are widespread in the United States and Europe, there are only about 18 in the UK, including one at Cambridge.

But the Oxford equipment will be the most advanced and because it features two consoles, is the only one of its kind to date in the UK.

Two consoles offer the chance for two surgeons with different levels of expertise and possibly with different specialist interests, to work together, and offers important training opportunities.

Prof Freddie Hamdy, the Nuffield Professor of Surgery at Oxford University, said: “I’m delighted that we’ve been able to obtain the latest surgical robot for Oxford. This is a really exciting development for Oxford. This is where modern surgery is going.

“These robotic systems are revolutionising the way surgery is carried out, offering astonishing precision. Because there is such a high level of control and the keyhole surgery is now so precise, it is minimally invasive, meaning the recovery time for the patient is quicker.”

The system scales down the movements of the surgeon on the console’s fingertip controls, and transmits them to the robotic arms.

Prof Hamdy said: “There is always the possibility of fine tremor when a surgeon operates. This eliminates that, and with the improved vision it could become safer than conventional surgery, with reduced risks for the patient.”

He said the equipment enabled surgeons to sit comfortably, rather than having to stand for hours, during complicated procedures. But as a surgeon, he said the loss of tactile sensation while operating initially felt strange.

“At the console the surgeon is able to see in 3D and everything is magnified by ten to 15 times.

“The optics are fantastic. It’s not like learning a new operation, but rather learning to use new instrumentation to do old operations better, and with far better outcomes for the patient.

“But this needed further evaluation through new research.”

But he emphasised the surgeon and not the robot conducted the operation, with the surgery still reliant on the surgeon’s skill.

The da Vinci surgical system, from Intuitive in America, has been acquired by the Oxford Radcliffe Hospitals NHS Trust through an initiative led by the Nuffield Department of Surgery at Oxford University.

Funding was secured from a variety of research institutes, Oxford University, the Oxford Biomedical Research Centre and charities, including the Alison and Hanson trusts.

Although initially the cost of individual operations will be higher than conventional surgery, the ORH Trust will be emphasising the long-term savings and benefits to patients.

Moira Logie, a divisional director at the trust, said: “At the moment only patients funded by research and charitable funds can be treated with the robot.

“But we hope that NHS commissioners will support this technology in the future.”