Surgeon performs UK’s first robotic diaphragm procedure

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The UK’s first robotic diaphragm plication has taken place at The James Cook University Hospital in Middlesbrough.

Cardiothoracic surgeon Joel Dunning performed the leading edge procedure using the hospital’s new da Vinci robot.

James Cook is only the second hospital in the country to offer robotic thoracic surgery and is now the first to use it to carry out a diaphragm plication – an operation to repair a paralysed diaphragm.

“A paralysed diaphragm can leave you feeling very out of breath,” said Mr Dunning. “Normally you would have to have a big thoracotomy which is very painful and you can be out of action for up to six weeks, but with this endoscopic technique patients can be back home within two to four days.

“It’s technically very difficult to do because it requires a lot of stitching but that’s what the robot is so good at doing.”

Together with the world’s first robotic thoracic surgeon Franca Melfi, Mr Dunning and his team performed the UK’s first robotic diaphragm plication at James Cook on Monday 13 April.

UK's first robotic diaphragm procedure

“We are very pleased to say it went perfectly and the patient was up that very evening saying his breathing felt better already,” said Mr Dunning.

The robot arms control long instruments that go into the chest through three to four small holes of about 8mm. The surgeon sits at the console throughout the procedure and has full control of the robot and excellent vision via a 3D camera.

Mr Dunning added: “I rely very heavily on a team that are scrubbed up next to the robot. We have been practising for months and are very excited to have achieved this national first.

“The real advantage of the robot is that the instruments are so controllable inside the chest and can move in every direction – plus the robot has three arms compared to my two!

“Patients benefit from the robot’s brilliant accuracy and vision and we hope this new technique will also significantly speed up their recovery.”

Michael’s story

Cardiothoracic surgeon Joel Dunning and patient Michael Jackson

Tyneside Granddad Michael Jackson was the first patient to undergo robotic diaphragm surgery in the UK.

Michael had been suffering from problems with his breathing following a car crash in 2008. After months of tests the retired sales manager was told that the stabbing pain in the chest was being caused by damage to his phrenic nerve and the only way to repair it would be major surgery.

At first Michael opted not to have the operation as he did not want to spend weeks out of action but when it got to the point that it was getting difficult for him to lift up his grandchildren Rose, 7 and Poppy, 3, he knew he had to do something about it.

His wife Teresa searched the internet and discovered that the surgery could be done using keyhole procedures at James Cook.

“I like to think I’m quite fit but this was killing me,” said Michael, 68, who returned to his home near Whitley Bay two days after the operation.

“When I went to see Mr Dunning he offered me the robotic surgery and I was not bothered about being the first to try it.

“When I woke up I could breathe better straight away. In fact I have not felt this well for at least five years!”