UK first for robotic breast reconstruction surgery
Surgeons from our Trust and The Royal Free Hospital have performed the first robotically assisted surgery in the UK to help build a new breast, on a patient from Hillingdon.
They used the da Vinci robot to take a blood vessel and surrounding tissue from 52-year-old Patricia Carroll's abdomen to create the breast. Using the robot, rather than completing the surgery manually, reduced the length of the operation by three hours. They were supported, live, by a colleague thousands of miles away in the USA.
Hillingdon also has a da Vinci robot and recently celebrated a milestone: 500 procedures performed using the technology.
Last year, the surgeons successfully used keyhole surgery for the first time for this kind of reconstruction, known as DIEP flap surgery. Ordinarily surgeons need to make a 12cm incision in a patient's abdominal wall to harvest the blood vessels for a 'flap' of tissue. The keyhole surgery meant only a 2cm incision was needed but surgeons always viewed that as a stepping stone to performing this element of the surgery robotically.
Crucially the robot allows more control, enabling far less injury to surrounding tissue. Ten times magnification also allows for far more precision, making the process safer.
The journey towards the robotic surgery has been a collaboration between Dariush Nikkhah, a consultant plastic surgeon at the Royal Free Hospital, and Alistair Slessser, a consultant colorectal surgeon at Hillingdon Hospital in Pield Heath Road, Uxbridge. For this surgery they were joined on a virtual link from the United States by Jessie Selber, who pioneered the robotic technique, so he could be there if the surgeons had any questions. In addition, Royal Free London plastic surgeons Shadi Ghali and Stephen Hamilton and colorectal surgeons Reza Mirnezam and Ibnauf Suliman were also in attendance.
Patricia, who works in financial services, had a mastectomy in 2019 following a breast cancer diagnosis after noticing a strange pain in her arm. She wondered if she had arthritis, but further investigation showed she had three lumps in her right breast and what she had been experiencing had been lymph pain.
She said: “If I can help other women by telling my story then I'm happy to. Having cancer has been tough but I can honestly say it has changed my life for the better. It gave me a wake-up call, and I feel healthier than I have ever done in my life.”
Patricia credits meditation for helping her mentally and physically but even she was shocked at the impact of robotic surgery.
She said: “I've had no pain in my abdomen whatsoever. Meditation helped but I absolutely credit the robot.”
Mr Nikkhah said: “We'd been planning this for months and it has brought a lot of joy to everyone involved - it's all anyone in theatres can talk about since! I'm so proud of our medical and nursing teams. Minimal access surgery can reduce problems such as hernias and bulges and will shorten inpatient stay - Patricia only stayed for three days, and I predict that one day patients will be able to go home the next day. I hope we will be able to carry out at least 10 more robotic surgery cases this year.”
Patricia will have to wait another few weeks until she can restart her yoga and power walking, but her goal is to be healed enough to support her 85-year-old mother who needs physical assistance to get out and about.
Patricia has nothing but praise for the surgeons and staff who cared for her at the end of February.
She said: “Everyone has been so professional and so personable. They answered all my questions and kept me incredibly safe. I feel very lucky to have been part of this incredible surgery.”