Robot prostate surgeons help London hospital set world record

Doctors who performed the Aquablation surgery  (Guy’s and St Thomas’ NHS Trust)
Doctors who performed the Aquablation surgery (Guy’s and St Thomas’ NHS Trust)

Surgeons at a London hospital have used a pioneering robotic technique to treat a record number of men with enlarged prostates in a single day.

Doctors at Guy’s Hospital performed the Aquablation procedure on 10 patients in a day – the most of any hospital in the world.

Aquablation is a heat-free robotic system which uses advanced surgical mapping to create a bespoke surgical plan, water and real-time imaging to remove overgrown prostate tissue.

The procedure takes around 40 minutes and is more precise and standardised than other treatments.

It is used on men who have benign enlarged prostates, a common condition in men over 50 years of age. Symptoms can include feeling the need to urinate more often and some men have to have a catheter inserted into their bladder while waiting for treatment, which can affect their quality of life.

The condition can be treated with medication when mild, though larger prostrates may require surgery to manage obstructive urinary symptoms.

Conventional surgical treatment for benign, enlarged prostates would usually use a laser technology known as HoLEP – though this can take up to three hours for each patient and can be challenging to perform on larger prostates.

Rick Popert and Jonathan Noël, consultant urological surgeons at Guy’s and St Thomas’, along with their surgical teams have been operating using Aquablation to help tackle a backlog of patients waiting for treatment.

For their latest High Intensity Theatre (HIT) list, their team operated on 10 patients with one Aquabeam robotic system.

This was done across two operating theatres and using three teams of theatre staff.

Mr Popert said: “Using this technique we can do twice the number of patients we’re able to do with more conventional surgery, and it’s easier and quicker to train more surgeons to be able to do it. This enables us to offer more patients better surgery.”

High Intensity Theatre lists (HIT) focus on one procedure at a time and seek to minimise the turnaround time between operations. Using two theatres, the surgeon can go between cases without having to wait for a patient to come in. This helps to cut the significant amount of time it takes for medics to anaesthetise a patient, set up equipment in the theatre and help them to recover – a process which sometimes takes longer than the operation itself.

John Wade was treated with aquablation (Guy’s and St Thomas' NHS Trust)
John Wade was treated with aquablation (Guy’s and St Thomas' NHS Trust)

Mr Popert said the HIT list was delivered with “military precision” by NHS staff and could be applied to all surgical specialties.

“They could be used throughout the NHS as a blue print to help tackle the rising tide of surgical waiting lists”.

Last week, the Standard revealed how over a million Londoners were waiting for routine treatment at the end of October. It is one of the most significant issues facing the NHS in the coming years, with the health service also grappling with strikes and delays in A&E.

The HIT list is the 20th carried out at Guy’s and St Thomas’.

In October, surgeons at the hospital performed eight robot assisted radical prostatectomy operations in under ten hours, the highest number performed in a single day in the UK in one hospital.

Dr Imran Ahmad, a consultant anaesthetist at Guy’s and St Thomas’ who developed the system, said: “We were very excited to combine the innovation of HIT lists with the cutting edge technology of Aquablation prostate surgery and operate on a record number of patients in one day.”

Retired dentist John Wade, 69, was one of the first Aquablation patients at Guy’s Hospital, following previous prostate surgery which didn’t fully resolve his issue.

John, from Norwich in Norfolk, said: “This procedure was so much ‘kinder’ to me physically than the one I had had previously. This is medicine moving forwards – it was first class.”