A hysterectomy, performed as traditional, open abdominal surgery, can require a three to five day hospital stay with between six and eight weeks of recovery at home.
In recent years, techniques to make the operation less invasive (minimal access surgery where there is evidence to support its use), has reduced the length of hospital stay to one to two days but actual day case surgery is still at pioneering stage in the UK.
But now, Rosemere Cancer Centre has performed its first day case hysterectomy using a robotic surgical system on a 31-year-old woman with womb cancer.
A day case means a patient goes into hospital in the morning, has the procedure and then goes home later that same day.
The procedure was done by consultant gynaecological oncologist Nick Wood.He says: “The procedure went very well.“It was a first in our region – Lancashire and South Cumbria – and, as far as I’m aware, not yet widely being undertaken. “It is also not suitable for all patients in need of a hysterectomy. “There are various factors involved in deciding whether or not it is feasible but it highlights the advanced capabilities we now have thanks to the robotic surgical system bought by Rosemere Cancer Foundation with the public’s donations.“It enables us to operate with such keyhole precision that post-operatively, the patient experiences much less pain with a reduced risk of complications so requires less recovery and less nursing, which in turn is not only beneficial to them but also to the NHS in terms of related costs – the need for a bed, nursing, pain relief and other medicines.”
Both the patient and Mr Wood were excited about the pioneering surgery and its outcome.
Mr Wood adds: “This was not entirely planned but I had a highly motivated patient and a very motivated team, which was great.“It was a big team effort. We are excited as it is a operation that minimises pain patients would normally experience afterwards and people wake up feeling less drowsy or sick. “We are doing our bit to make sure patients wake up more comfortable and are ready to eat and drink and get out of bed.”
The arrival of the robotic surgical system, the Da Vinci Xi, in spring 2017 has also enabled Mr Wood and his fellow surgeons to carry out keyhole hysterectomies on patients with high BMIs (body mass indices) – clinically obese women once regarded as unsuitable for such surgery and in some cases, for the risk of any surgery at all.
Mr Wood explains: “There is a positive association between obesity and the incidence of many gynaecological cancers, including endometrial cancer, which is cancer of the lining of the womb. “Clinically, the treatment outcomes for obese women have been less favourable, especially in cases where alternative treatment to surgery such as relying on radiotherapy alone or in combination with chemotherapy has had to be found. “However, we are now in a position to undertake keyhole hysterectomies in women with higher BMIs in many cases.”
Rosemere Cancer Foundation works to fund cutting edge equipment such as the Da Vinci Xi, the most advanced robotic surgical system available, which is also being used to treat patients with a variety of other cancers including bowel cancer and kidney cancers.
It also funds research and other cancer services that are beyond limited NHS resources to bring world class treatment to cancer patients from throughout Lancashire and South Cumbria being treated not only at Rosemere Cancer Centre but also at another eight local hospital cancer units across Lancashire and South Cumbria.