In Business Operation Robot

Listen to Operation Robot (02/12/2010)

The other day I watched something wonderful happen. A patient on an operating table was cured ... in front of my eyes.

This was not religion; it happened in an NHS hospital, Glenfield Hospital in Leicester. Brian Watts had been suffering from heart flutters for some time. Some days – he told me from his hospital bed before the operation – it was so bad he had to go back to bed.

Previous attempts to improve his condition had had little lasting impact, including the insertion of a pig's heart valve.

After he had been prepared, Brian was taken into the operating room, and I went in too, not all scrubbed up nor in surgical garb, but just as I had arrived that morning.

We sat in a partitioned off section of the room with an array of monitor screens in front of us. Brian – dosed with pain relievers but conscious – lay on a table a few yards away with blue–gowned medics looking after him.

Two large white machines hovered over him: a very manoeuvrable X–ray head feeding live images to a one of the screens in front of me, and at the other end a long robot arm ... the reason I was observing this operation with such close attention as well as an In Business microphone.


Robot surgery is bringing revolutionary changes to the way healthcare works.

This robot–assisted operation for an irregular heartbeat was done for the first time anywhere in the world here in Leicester in April by the consultant cardiologist Dr Andre Ng.

This time he talked me through the procedure as he did it.

First Dr Ng and his team pushed two catheters through a keyhole incision in Brian's groin, and manoeuvred them up towards his heart, beating away on the X–ray screen.

Then the catheters pick up electric signals from the heart ... so that that on another screen in front of us you could see the way the tiny electric currents were conducted across the heart's surface, causing heart flutters.

The conductivity is normally blocked by non–conducting fibre at the base of the heart. But this was not happening; as a result, Brian's heart was short–circuiting.

Then, using a robot controller resembling an electric toothbrush, Dr Ng edged a third catheter with an "ablation" tip into place. Meanwhile the heart monitor kept blipping ... a v–shaped dip on the electronic graph, he called it a "chevron".

When these keyhole operations are done by hand, the specialists are liable to get big doses of radiation from operation after operation in the course of a day. They wear heavy lead jackets on top of the surgical scrubs to lessen the dangerous effects of the X–rays, very tiring after hours in the theatre.

The robot enables the specialist in charge to sit well away from the source of the radiation.

Satisfied that things were in position, Dr Ng activated the welding head of the third catheter: "cooking" is what he called it.

Dot by dot, the tiny burner tip moved across the surface of the heart. Each "cook" lasted about a minute, creating a barrier the electric current cannot cross.

As the procedure continued, the V–shaped blip on the heart monitor screen began to decrease. After a few minutes, it was gone altogether. Brian's heart flutter was cured.


Robot surgery is going to be applied to many other conditions. For example, when operating on prostate cancer it has been difficult to avoid severing tiny nerves close to the cancer, an action which can render the patient both impotent and incontinent.

But by carefully mapping the body round the prostate gland, the computer can blank out very detailed areas, creating a no–go zone for robot–assisted surgery so that nerves close to the tumour cannot be harmed.

It is important to stress that this is human–hand surgery assisted by robots.

The surgeon stays in charge, but the robot helps to achieve what is said to be a much more accurate and controlled result. Robots don't have shaky hands, for example, and if the surgeon happens to shake, than the robot eliminates the effect.

Very important work on the application of robots is now being carried out at the Hamlyn Centre for Robotic surgery at Imperial College London, and at the Sant'Anna School of Advanced Studies near Pisa in Italy.

There are big medical and business implications.

Linking small body sensors to mobile phones may enable doctors and hospitals to monitor patients from a distance, picking up tiny signals of troublesome conditions long before they present themselves as symptoms.

This may lead to healthcare becoming much more preventative and much less dominated by patient events which call for surgery or other large interventions. It will probably require healthcare to be organised in a very different way: and need very different assumptions from patients and practitioners,

Whatever happens, I will not quickly forget the day I saw a man cured in front of my eyes.

Listen to Operation Robot (02/12/2010)

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