Innovation
respectively. There were no intraoperative complications, and the postoperative transfusion rate was 0.2%. The mean hospital stay was 1.7 nights, and duration of catheterisation was 12 days. Final pathology demonstrated a mean prostate weight of 40.0g and 14.5% replacement by cancer, most commonly Gleason 7. The positive surgical margin rate for pT2 tumours was 10.0%. Biochemical recurrence was 2.1% at a mean follow-up of 18.0 months. Continence and potency rates at 4 weeks and 1 year after surgery were 76.4% and 97.7% and 27.8% and 78.1%, respectively. The trifecta and pentafecta rates 1 year after surgery were 53.1% and 45.8%. Arista applied to the prostate bed at the end of RARP was shown to be a safe, easily applied and useful adjunct to conventional haemostasis. Mr Abou-Chedid now uses Arista as part
of a Retzius sparing, clipless prostatectomy technique, to effectively control bleeding without compromising post-prostatectomy functional outcomes. He also points out that the move to clipless RARP, from standard RARP, can achieve a cost saving of £231.77 per patient, making this a cost-effective option.
Investing in innovation Matthew Perry said: “We need to be creative in the way we tackle increased demand on our services and the Urology Team have been very effective at coming up with ways to safely improve experience for patients, reduce waiting times, while maximising the use of our resources. The Trust’s investment in our cutting- edge robotic technology is playing a vital role at the heart of this drive.” The Trust continues to invest in innovation
and another new robot has now arrived at Royal Surrey NHS Foundation Trust in a bid to help deal with an increase in demand for surgery. The new DaVinci robot is the fourth to be commissioned at the Trust, making it one of the best resourced robotic centres in the UK and helping to reduce waiting lists for surgical procedures. It will enable surgery to be carried out on
more than 100 extra patients a year initially, which will increase exponentially once the appropriate theatre space and manpower is made available through the opening of a new Cancer and Surgical Innovation Centre, on the Royal Surrey County Hospital site. The robot will eventually be part of the new centre, but its delivery was brought forward to help a higher number of patients receive minimally invasive surgery more quickly. Ross Dunworth, Deputy Chief Executive, said:
“We are really excited to acquire the new robot at Royal Surrey, which will make a positive difference to our patients and enable more of
our clinicians to expand their skill set and train the next generation in this growing field. “This is all part of our drive and mission to be at the forefront of medical advances and technology; particularly as we are one of the biggest cancer centres in England and carry out a high number of complex cancer surgeries. “Work is now underway in the new Cancer and
Surgical Innovation Centre and, when complete, this will be a major new development. “With our exceptionally skilled surgical and
cancer teams and four robots at our disposal, we will be well placed to continue providing outstanding care to patients across the South East and beyond.”
References 1. Broe M, Carbin Joseph DD, Casson H, Innes M, Adamou C, Fragkoulis G, Moschonas D, Kusuma VRM, Hicks J, Patil K, Perry MJA, Abou-Chedid. W. Assessment of routine
same-day discharge surgery for robot-assisted radical prostatectomy. World J Urol. 2023 Oct;41(10):2679-2684. doi: 10.1007/s00345-023-04566-x. Epub 2023 Sep 5. PMID: 37668719.
2. BAUS 2023, poster abstract, Abou-Chedid et al, Self-removal of Catheter after Robot Assisted Radical Prostatectomy – Saving the Planet One Catheter at a Time.
3. Abou-Chedid, W., Carbin, D.D., Innes, M. et al. Self-removal of catheter after robot-assisted radical prostatectomy: a feasibility study. J Robotic Surg 17, 2697–2701 (2023). https://doi. org/10.1007/s11701-023-01690-z
CSJ
4. Abou-Chedid W, Janardanan S, Kavanagh L, Eden C. A pilot study to investigate the effect of topical microporous polysaccharide haemospheres on outcomes following robot- assisted radical prostatectomy. Ann R Coll Surg Engl. 2022 Jan;104(1):24-27. doi: 1 0.1308/rcsann.2021.0128.
Centre of Excellence: an insight
into innovation and best practice Mr Wissam Abou-Chedid recently provided an insight into Retzius-sparing prostatectomy (posterior approach), nerve preservation, same- day surgery and clipless surgery at an EMEA Centre of Excellence, in partnership with BD. The objective was to share innovative best practice in RARP with an eye on sustainable patient outcomes. To date, there have been two dedicated Centre of Excellence sessions: one for UKI surgeons and one specifically for French surgeons.
These evenings start with a practical
presentation on the data, roadmap, findings and how to implement these groundbreaking pathways in your own department. Next day, the visiting surgeons are invited into the Operating Room to observe first-hand how Mr Abou-Chedid performs his surgery. Given the feedback and success of these workshops, further sessions are now planned for the future. For details of the next session, email:
Noel.Kelly@
bd.com
July 2024 I
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