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Robot-assisted surgery boost for bladder cancer care

Monday May 16th 2022

Robot assisted surgery has improved recovery times for patients undergoing treatment for bladder cancer, according to the findings of a major UK trial published yesterday.

Surgeons who worked on the trial in London and Sheffield called for a rethink of the use of open surgery for these treatments after showing the new technology halved the risk of readmission.

The trial also showed a 77% reduction in the prevalence of deep vein thrombosis.

The robotic systems used for the trial allowed surgeons to conduct major operations using minimally invasive techniques, aided by a console and 3D viewing.

The study was published in the Journal of the American Medical Association and also reported to the conference of the American Urological Association.

Surgeons randomised 338 patients with non-metastatic bladder cancer into two groups for radical cystectomy and intracorporeal reconstruction. One group was treated through robot-assisted minimal invasive surgery and the other had open surgery.

Researcher Professor John Kelly, of UCL London, said: “Despite robot-assisted surgery becoming more widely available, there has been no significant clinical evaluation of its overall benefit to patients’ recovery.

“In this study we wanted to establish if robot-assisted surgery, when compared to open surgery, reduced time spent in hospital, reduced readmissions, and led to better levels of fitness and quality of life; on all counts this was shown.

“An unexpected finding was the striking reduction in blood clots in patients receiving robotic surgery; this indicates a safe surgery with patients benefiting from far fewer complications, early mobilisation and a quicker return to normal life.”

He added: “In light of the positive findings, the perception of open surgery as the gold standard for major surgeries is now being challenged for the first time.

“We hope that all eligible patients needing major abdominal operations can now be offered the option of having robotic surgery.”

Fellow researcher Professor James Catto, of the University of Sheffield, said: “This is an important finding. Time in hospital is reduced and recovery is faster when using this advanced surgery.

“Ultimately, this will reduce bed pressures on the NHS and allow patients to return home more quickly. We see fewer complications from the improved mobility and less time spent in bed.

“The study also points to future trends in healthcare. Soon, we may be able to monitor recovery after discharge, to find those developing problems. It is possible that tracking walking levels would highlight those who need a district nurse visit or perhaps a check-up sooner in the hospital.”

Effect of Robot-Assisted Radical Cystectomy With Intracorporeal Urinary Diversion vs Open Radical Cystectomy on 90-Day Morbidity and Mortality Among Patients With Bladder Cancer: A Randomized Clinical Trial JAMA 15 May 2022; doi: 10.1001/jama.2022.7393

[abstract]

Tags: Cancer | Internal Medicine | UK News

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