First robotic oesophagectomy in Australia

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Robot technology is bringing big benefits to sufferers of a less common form of cancer at Sydney’s St George Private Hospital.

Early this year, Associate Professor Michael Talbot performed the first robotic oesophagectomy in Australia, the hospital said.

The procedure – removal of the diseased part of the oesophagus and the upper part of the stomach – is often risky and complex.

A/Prof Talbot said minimally-invasive robotic surgery takes around the same time as open or laparoscopic techniques – 4-6 hours – but recovery is halved and patients can usually leave hospital after a week.

“They can avoid having a large abdominal and chest incision, which is required with the traditional open procedure. The smaller incisions lead to a faster recovery, earlier commencement of diet and ultimately an earlier discharge from hospital,” he said.

“This type of minimally-invasive oesophagectomy, laparoscopic or robotic, is less commonly performed than open surgery, but trials have shown a lesser complication rate and improved cancer survival.”

Oesophageal cancer affects 1,400 Australians every year, according to the Cancer Council, and is three times more likely in men than women, being more prevalent in those over the age of 60.

Globally it is the eighth most common form of cancer, with the highest incidence in Africa and Asia.

If not treated early it can quickly spread from the gullet to the rest of the body, causing problems such as malnutrition, reflux and inability to eat solids.

While robot technology had been available for over a decade in other types of surgery, such as urology, A/Prof Talbot said it previously was not easily applicable to other abdominal procedures.

However, recent improvements have made it more flexible – and the opening up of the robotic patents market will mean costs come down and make such surgery more routine.

“Pricing of the robot has prevented it from being available to most patients and surgeons. Once these tools are made available to more surgeons we will use them more,” said A/Prof Talbot, who used a Da Vinci XI robot platform that the Kogarah-based hospital bought in 2016 for January’s breakthrough operation.

“The next decade is likely to see a transformation in how we perform surgical procedures across the board with the use of training models, semi-autonomous systems to reduce error, modelling technologies for surgical planning etc,” he added.

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