Surgeons at The Royal Marsden NHS Foundation Trust are using an innovative robotic microsurgery system, funded by The Royal Marsden Cancer Charity which will support advancements in minimally invasive cancer surgery.
The Symani® Surgical System is a teleoperated robotic platform designed for microsurgery – a highly specialised technique where surgeons repair tiny anatomical structures such as blood or lymphatic vessels, or nerves. This restores blood flow or enables the redirection of fluid, for example with lymphoedema.
After cancer resection, microsurgical reconstruction plays an essential part in restoring both function and appearance. It enables reliable wound healing and helps patients regain their quality of life by reconstructing tissues and structures that were removed during cancer treatment.
Symani will allow surgeons at The Royal Marsden to operate with increased precision on tiny vessels – usually less than one millimetre in diameter – using the world’s smallest wristed robotic instruments.
It enables them to replicate the natural movements of the human hand at the micro scale, and reach difficult-to-access anatomy to reconnect delicate vessels.
Nick Lees, 47, from Godalming, was the first patient to be treated using Symani at The Royal Marsden. He was diagnosed with dermatofibrosarcoma protuberans (DFSP), a rare type of soft tissue sarcoma, in his chest.
He was referred to The Royal Marsden, where he underwent the removal of the tumour, followed by reconstruction using tissue from elsewhere on his body. This was connected to blood vessels at the site, using Symani.
“Getting a cancer diagnosis last year was completely unexpected and a huge shock,” Nick said. “I feel incredibly lucky, and proud, to have had the opportunity to benefit from this robotic surgery, all thanks to The Royal Marsden Cancer Charity. Being the first person in the UK to have this surgery using this system is definitely something I’ll be telling my grandchildren about one day!
“Recovery from my surgery has been excellent, and everything is healing really well. I’m certain I wouldn’t be doing as well, or recovering as quickly after such a major operation, if I hadn’t been treated with this new robotic technology. I’ve been so impressed with The Royal Marsden from the very beginning – it’s been a truly humbling experience and has given me a new perspective on so many things.”
“We are hugely excited by the potential of Symani and the possibilities it offers patients in terms of faster recovery, less pain and improving quality of life following surgery,” said Mr Kieran Power, Head of the Plastic Surgery Unit and Consultant Plastic and Reconstructive Surgeon at The Royal Marsden.
“Thanks to hugely generous supporters of The Royal Marsden Cancer Charity, we have the opportunity to play a leading role in this field, helping to develop new, less invasive surgical options that will benefit patients worldwide.”
Mr Aadil Khan, Consultant Plastic Surgeon and Reconstructive Surgeon at The Royal Marsden, added: “Robotics has enabled some incredible advances across healthcare, and using Symani, we hope to be able to refine and improve reconstructive microsurgery techniques used to treat a range of cancers.
“The expertise of our multidisciplinary team at The Royal Marsden not only enables us to bring the benefits of this pioneering technology to patients as soon as possible, but it also means we are uniquely placed to evaluate Symani and carry out extensive research in this area across different cancer types.
“Our goal is to share learnings with colleagues across the NHS for the benefit of patients across the UK and beyond.”
Using Symani, The Royal Marsden has established ‘INnovations in robotiC mIcroSurgEry’ (INCISE) – the UK’s first programme of clinical and translational studies to evaluate its effectiveness and develop evidence-based clinical studies to assess the benefits of robotic microsurgery.
Currently, around 30 per cent of breast cancer patients develop lymphoedema following treatment. The INCISE programme intends to combine breast reconstruction with lymphatic microsurgical repair, to prevent the development of lymphoedema and reduce complications at the site where tissue is removed.
More widely, the team hope to use Symani in other kinds of lymphoedema surgery, and to treat other cancer types such as lung, skin, gynaecological and urological.
Symani could also help provide options for nerve repair for head and neck cancer patients. Current procedures can be invasive, and can significantly impact a patient’s ability to swallow and their speech. In severe cases, it can cause facial paralysis, and these patients require a long recovery in hospital.
INCISE aims to test if Symani can be used to help surgeons perform complex procedures like nerve repair with improved precision and control, potentially supporting the return of normal swallowing and speech, reducing the length of stay in hospital and improving patients’ quality of life.
The three-year lease of the Symani Surgical System has been made possible thanks to the Denise Coates Foundation and Mrs Emma Bishop’s generous support of The Royal Marsden Cancer Charity.
Pictured: Aadil Khan and Kieran Power with the Symani Surgical System by MMI (Medical Microinstruments Inc.)
