Surgeons' skills key in bowel cancer surgery

NEVER MIND expensive, high-tech surgical robots. Real live surgeons must constantly improve their techniques in precision surgery to give bowel cancer patients the best possible chance of survival and good quality of life, a major surgical conference in Galway will hear this weekend.

Professor of surgery at the North Hampshire Hospital and surgical director of the Pelican Cancer Centre, Basingstoke, RJ Heald said a high standard of precision surgery should be available to everybody who gets colorectal cancer.

The internationally renowned surgeon pioneered the Total Mesorectal Excision (TME) technique, which has become the gold standard for the treatment of bowel cancer as it improves cure rates and reduces local recurrence.

With TME, not only is the tumour removed but all of the surrounding fat, lymph glands and blood vessels to minimise the risk of the cancer recurring.

Prof Heald will deliver the memorial lecture at the 36th Sir Peter Freyer surgical symposium at NUI Galway this weekend. The title of his lecture is Colorectal Cancer Surgery – Open, Keyhole, Endoscope or Robot . . . Where are We Going?.

Colorectal cancer, commonly known as bowel cancer, is the third most commonly diagnosed major cancer in the world and the second most common cancer in Ireland.

Prof Heald said: “Open surgery is the standard, basic and still commonest way of dealing with colorectal cancer and many would say still the safest.

“However, many leading laparoscopic surgeons say they can do an equally good job with keyhole surgery.

“They have the advantage of being able to get imaging devices into corners where it can be difficult to get instruments and get a magnified image. There are pros and cons for both.”

In relation to the use of the surgical robot in colorectal surgery, Prof Heald said that “if you wanted to be cynical, you could call it the most expensive needle holder in the business” as it’s still a surgeon doing the operation at the end of the day and not a robot.

“My message is that precision is key in this type of surgery. It is perfectly clear that across large swathes of the world – including eastern Europe and South Africa – the cost of the surgical robot is quite disproportionate to the benefits it is likely to bring.

“On the other hand, we can develop processes to do better open and laparoscopic surgery without having to spend such disproportionate sums.”

Prof Eilis McGovern, president of the Royal College of Surgeons in Ireland and consultant cardiothoracic surgeon at St James’s Hospital, will present a lecture on the second day of the symposium entitled Surgical Training and Surgical Service – Are we getting the Formula Right?