SURGERY
a polyethylene cord which causes them to grow straight. For patients, it means that the spine can be left flexible rather than rigid. While the surgery is usually performed
as a mini-open procedure using one small incision, the surgeons trialling it in the UK are using a minimally-invasive keyhole thoracoscopic approach, making the demonstration a UK- and world-first. David Baxter, consultant neurosurgeon, Defence Medical Services, commented: “We are proud to be the first to trial this new promising technique in the UK and to be leading a simulation of it at this year’s Future Surgery Show.
“What’s really unique and exciting about
vertebral body tethering is that we are the only people doing it at the moment in the UK, and we perform it through a keyhole thoracoscope – whereas the places that undertake it in the US and Germany perform it through a bigger open cut in the chest. As a technique it is truly ground-breaking, allowing kids to get back to elite sport or dancing or swimming within a couple of weeks of having the surgery, and it straightens their spine without having to fracture it meaning it retains flexibility.” For the last 50 years the main technique for treating adolescent idiopathic scoliosis, a condition which affects children between 10 and 18 and for which there is no definable cause, has been traditional spinal fusion. The basis of this surgery is a fusion process – fracturing the bones in the spine, putting them into the correct place and fusing them together, so they can heal into one solid unit. While effective, the treatment means that the spine becomes rigid and usually takes 6-9 months to recover from while the bones fuse together. In the last 10 years, the desire to maintain spine motion has fuelled the development of various growth modulation procedures. One of these promising techniques that has gained traction is vertebral body tethering (VBT).
VBT is a thoracoscopic, fusionless treatment option that is considered as a new promising method for the management of adolescent idiopathic scoliosis, without causing any major complications. During the procedure, screws are placed into the side of the spine which are connected by a flexible cord rather than a metal rod. The screws are placed into the middle of the vertebral body under thorascopic guidance. A polypropylene tether is then placed into the screw heads to guide future growth of the spine. For patients, the recovery period is only the length of time it takes for the scars to heal, which is approximately two weeks, meaning children can resume sports activities immediately.
JANUARY 2022
Live robotic partial nephrectomy Surgeons at Guy’s Hospital also used cutting- edge technology to perform robotic partial nephrectomy live on the ABHI Surgical Simulation at Future Surgery Show 2021. Mr Ben Challacombe, consultant urological surgeon at Guy’s and St Thomas’, led the robotic partial nephrectomy (partial kidney removal) on one of the Trust’s patients at Future Surgery 2021. The surgeon used the DaVinci robot to make smaller incisions to remove the part of the kidney, avoiding larger cuts and more scarring.
The procedure was live streamed to the exhibition via Proximie – a technology platform that allows clinicians to virtually ‘scrub in’ to any operating room or cath lab from anywhere in the world. Robotic partial nephrectomy (partial kidney removal) is a delicate procedure used to treat kidney cancer, while sparing as
much healthy kidney tissue from damage or removal as possible. The minimally invasive approach, which can be performed using very small incisions, gives equal cancer control to that of open surgery and makes for an easier recovery after surgery. Patients who have a small tumour in their kidney are suitable for a partial nephrectomy. During the procedure, fine articulating instruments are used to precisely remove the tumour alone and preserve the remaining kidney.
Mr Challacombe said: “Robotic partial kidney removal has several benefits for patients over both standard keyhole and open surgery, including less time in hospital, faster recovery times and less pain. When Surgeons use the robots, they effectively have their hands inside the patient without open surgery. We can perform the key part of the procedure in less time using the robot,
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