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How a digital-first, collaborative service is setting new standards in colorectal surgery

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Health Tech World reports on the pioneering work of the precision surgery group at London’s King Edward VII’s Hospital.

There’s no denying that the pandemic has marked a shift in how healthcare is – and will be – delivered in the UK.

Healthcare professionals have been forced to innovate and drive change at rates faster than ever before, with adoption of technological solutions driving collaboration between teams, hospitals and the NHS and private sector, in some cases for the first time. 

One area that demonstrates this is in colorectal medicine. The precision surgery group, a specialist, world-renowned colorectal robotics team has recently brought its service to King Edward VII’s Hospital, championing a new, collaborative, digital-first and data-driven approach to treating colorectal cancers, benign colorectal conditions and hernias.

Data driven advancement 

The team comprises the UK’s most experienced surgeons in the field of colorectal robotics, Mr Danilo Miskovic and Mr Charles Evans, both proctors, as well as consultant colorectal surgeons Mr James Kinross and Mr Alex von Roon.

Between them the team has performed over 500 major robotic colorectal procedures and so has access to a wealth of data, which can be analysed and shared with the rest of the medical community, helping to identify patterns and improve outcomes for patients.

Mr Miskovic explains: “Traditionally and especially in the private sector, colorectal consultants work largely alone, which can create silos.

“This can stifle improvements and innovations, as it makes it harder to share learnings and identify patterns, and there isn’t the data to support changes to how we work. 

“We are hoping to foster a more collaborative approach. This is currently the gold standard for service provision, but in time it should become the norm.”

Latest technology

The team’s approach is underpinned by the state-of-the-art technology used to carry out surgical procedures.

The hospital’s da Vinci Xi robot delivers the highest quality surgery with faster recovery times, less pain and discomfort, fewer complications and a shorter hospital stay for patients. 

Mr von Roon explains: “The use of robotic technology lends itself to complex abdominal operations, as it enables the surgeon to perform precise, minute movements that would be difficult or in some circumstances impossible to reproduce with the human hand.

“This means that we can achieve a high level of precision, which is important when removing a cancerous tumour, for example.”

But of course, technology alone will never be enough. “Although the robotic tools we have at our disposal are at the cutting edge of today’s technology, they do not operate independently of the surgeon.

“It is more accurate to call a surgical robot a highly sophisticated surgical instrument that is completely under the control of the surgeon,” Mr von Roon adds. 

And the human touch will always be required. The service is delivered by highly skilled surgical and nursing teams, as well as physio and occupational therapists, utilising a mix of face-to-face and video consultations to provide end-to-end care. 

Digital-first approach 

At a time when everyone has been keen to keep inpatient care to a minimum, the team is looking at digital tools such as smartphone apps to keep in touch with their patients, both in advance of and following their hospital stays.

Mr Kinross explains: “The importance of patient reported data during recovery has long been understood as a key tool for improving outcomes, but increasingly we understand that the way our patients prepare for procedures is important too. Factors like the diet, activity levels and mindset all impact on outcomes.”

And as well as helping to maintain the surgeon-patient relationship, these digital tools also help the team to capture data.

“This is another way that we can build up a body of evidence to help us work towards securing the best outcomes for each patient,” adds Mr Kinross.

The future view

There’s no doubt that the last year has provided a ‘watershed’ moment for how technology is used in health. “There’s no going back,” says Mr Evans.

“From here we’ll see the patient journey becoming increasingly digitised, from the first GP referral, to picking up a prescription, surgical follow ups, physiotherapy and nurse consultations.”

Looking at robotic surgery specifically, Mr Miskovic says: “In the future more and more procedures will be carried out by robot-assisted surgery.

“There’s appetite for it both from patients and clinicians, and the team at King Edward VII’s Hospital and I are training more and more surgeons to carry out surgery in this way.

“I expect to see advancements in imaging too, helping us to pinpoint the exact location of the tumour so we can be even more precise. 

“Of course as doctors we would love to get to a point where we are diagnosing colorectal cancers earlier, so in many cases surgery could be avoided all together.

“But in the meantime, we must continue to innovate and adapt, and utilise technology to create the best possible services.”

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