Robotic Surgery

Hi Anthony,

Yes they started doing fully roboticised oesophagectomy at Royal Surrey Hospital in Guildford in January 2023. I didn't want to be the first so mine was only partially roboticised. It's less invasive if its done fully roboticised and so it's quicker to recover from, etc. My surgeon is a consultant/heads up his team - Nima Abbassi-Ghardi.  

Take care

Hi Suzie 

Thanks for your reply. I've since found out that not only is it available here in the UK but the first time it was carried out was at Gloucester Royal Hospital which is where my operation is being done!! I'm now wondering why it is not performed routinely if, as you say, the benefits to the patient are so great?

I'm assuming it's a case of expenditure as I'm certain that carrying out the keyhole/ robotic type of surgery is far more costly than the alternatives.

I shall be discussing this with my MDT to see what my options are. I understand that time is of the essence but equally as important is the recovery from what is a major operation.

Anthony 

Hi Anthony,

It might also be down to how confident each individual surgeon is with it. Last year before my surgery, the surgeons at RSH had only just started.  I know someone who had their surgery a few months later who wasn't given a choice really and had his done fully roboticised. You are right cost might be a factor though as those machines are eye wateringly expensive.  My surgery was paid through private health and they paid out more than a £1k per night on the surgical ward and much more in HDU. So I'm not sure how the cost compares.

Hopefully your discussion with your MDT will let you know their reasoning. 

Take care,

Suzie

Hi, 

I had the same surgeon as Suziew, my surgery end of Feb 2023 wasn't long after hers. I was apparently about the fifth person to have fully robotic at RSH. I was told I was ready to be released from ICU after 4 days although kept for 6 as they did not have general ward space. If I remember correctly I was then in general ward for three days before discharged.

Whilst in general I was opposite a gentleman of similar age, early 50''s, who had the normal operation three days before mine. I was walking unaided throughout the hospital a day after released to general whilst he had trouble exiting the ward. I was fetching him items from the hospital coffee shop at the entrance. My tumour was 12cm, his was 4cm if I recall correctly. 

After first day on general ward I was dressing as if ready to go home as, aside from sores from incisions I felt closer to 100% than I thought would have been possible, I fully expected to be admitted for up to three weeks for recovery. 

I had no leaks, and started eating solids within a few weeks of discharge. Which was not recommended. I started doing the school run a few days after discharge. Only issue I recall was going for a walk in nearby park about ten days after discharge and having very bad burning pain in chest after about half a mile and turning back. Otherwise no major problems and feel very lucky to have had the fully robotic.

All the best with yours, Steve

Hi Steve 

Thank you for the reply. I'm starting to feel like I've been "short -changed" and not been given all of the available options. Can I ask you a couple of important questions?

Firstly, whereabouts in your esophagus was your tumour?

Secondly, how long did the operation take?

Thirdly, did they deflate your lung during the operation and was there any damage to your ribs?

Many Thanks 

Anthony 

Embarrassingly I cannot remember the exact location, T4N1M0. However it was 12cm with part less than 1mm from aorta. After chemo I believe it was roughly 7cm. Surgery was just over 12hrs, no rib damage that I am aware of. They removed 71 lymph nodes with 7 found to have cancerous cells. 

I might have qualified for robotic due to size and proximity to aorta? 

I'm thinking it wouldn't have been offered due to the size and proximity as Suzi's was exactly the same size and location as mine and she was offered full robotic surgery 

Hi

I had full robotic Ivor Lewis oesophegtomy at Southampton General - by the team featured in the recent series Surgeons: Edge of Life (episode 'Hope' which was the exact operation). So, so interesting to see, they were amazing! I know watching surgery isn't for everyone, but I was spellbound by it.

My cancer was at the junction of oesophagus and stomach, and I've had two-thirds of oesophagus removed and half stomach... I think! (I can't remember exactly the proportions).

Although it's mostly keyhole, there is still a large-ish incision on the right side rib cage, and they also do deflate your lung to access the surgical site. I was only in ICU for one night! I did have complications just as I was about to go home, but am now 10 months post surgery and doing really well.