ADVANCED TECHNOLOGY Robotic surgery in progress at The Royal Marsden
Private Hospital award
As the first hospital in England to introduce the da Vinci Xi robotic surgical system – and now the only centre extensively using two da Vinci Xi models – The Royal Marsden has the most comprehensive programme of robotic surgery for cancer care in the UK. The award in the Private Hospital category for the second successive year recognises our depth of expertise in this area.
Our world-leading surgeons have performed 3,000 procedures in the past decade – and treated more than 500 patients in the past year – using robotically assisted techniques. These life-saving interventions have many benefits over conventional surgery, including a reduction in surgical trauma, minimised blood loss and speedier post-operative recovery.Our patients also benefit from a multidisciplinary approach during surgery, with a dedicated and specially trained team – including anaesthetists, specialist nursing staff and consultants – present in theatre.
In 2016, The Royal Marsden Cancer Charity funded the UK’s first multi-speciality Robotic Surgery Fellowship programme, which is training the next generation of surgeons to use the da Vinci Xi to operate across three tumour types – urological, colorectal and gynaecological – rather than just one. We have also established a unique transoral robotic surgery programme, which reduces the time patients spend in theatre and recovery. The Royal Marsden’s team uses the da Vinci Xi to provide better access and visualisation to the back of the mouth and lower down the throat, avoiding incisions to the neck and jaw.
Mr Pardeep Kumar, Consultant Urological Surgeon and Robotic Surgery Lead, says: “In the past decade, robotically assisted surgery has transformed how cancers are treated, and The Royal Marsden has driven this change. The expertise of our staff, the quality of our facilities and the success of our training elevates our status internationally for the benefit of patients.”
We have performed 3,000 robotic procedures in the past decade
Nursing Practice award
A multidisciplinary team approach for head and neck cancers
The Royal Marsden’s multidisciplinary team model ensures a robust and timely diagnosis and personalised treatment plans for all patients, improving their experience and quality of care. In particular, we have an international reputation for the care of cancer patients with complex needs, and this is enhanced by our Altered Airway Multidisciplinary Team (MDT). The Altered Airway MDT ward round is based on national standards of care and research that show that this approach can improve the care of patients with tracheostomies
and laryngectomies. Most commonly, patients with altered airways have gastrointestinal or head and neck cancers, and we are seeing increasing numbers of patients with these types of cancers.
In addition to the daily ward rounds by individual members of the team, the full team – which includes a speech and language therapist, a consultant lead, a dietitian, a physiotherapist, an advanced nurse practitioner, critical care outreach specialists, and ward nurses – visits each patient with an altered airway once a week. “The allied health professional and nurse-led model demonstrated in the MDT is a cost-effective way of providing evidence-based and enhanced care,” says Mo Carruthers, Divisional Nurse Director for Private Care.
“In other centres, similar ward rounds are led by the medical team. But at The Royal Marsden, those who are closer to the patient’s day-to-day needs lead the round. This ensures an improvement in interdisciplinary teamwork and an increased profile within the unit and with patients.”
Healthcare Outcomes award
PlasmaJet for gynaecologicalcancer patients
Ovarian cancer typically spreads on the surface of organs and tissue in the abdomen and pelvis, which means it is often difficult to surgically remove most or all of the tumour without damaging surrounding tissue. Because of this, surgeons often need to remove parts of the bowel, where the cancer is likely to have spread. This procedure means patients will require a stoma, which has a significant impact on their quality of life.
In 2013, The Royal Marsden became one of the first centres in the UK to introduce the PlasmaJet device, which uses plasma energy from ionised argon gas to cut through and dissect tissue, stop bleeding and destroy cancer cells safely. Unlike other surgical energy
devices, PlasmaJet can kill cells on the surface of organs and tissue while leaving healthy parts unaffected, meaning that there is no need to resect or remove these areas.
For delicate structures such as the bowel wall, it can safely ‘shave’ off less than a millimetre of tissue, which could not be achieved with any other device without damaging surrounding areas. Not only does this mean that ovarian cancer patients no longer need stomas, it also ultimately improves survival rates. “Without doubt, this has transformed treatment for our patients,” says Ms MarielleNobbenhuis, Consultant Gynaecological Oncology Surgeon. “With PlasmaJet, not only can surgeons completely remove or destroy all visible disease, it also means there is less need for bowel resection. “This offers the potential for actually curing these patients, as well as allowing us to treat areas of disease that couldn’t otherwise be treated.”
“Without doubt, PlasmaJet has transformed treatment for our patients”
High Growth award
The unique model of partnership between the private and NHS sectors
Private Care at The Royal Marsden is a unique proposition. It provides patients with access to the research, clinicians, governance structures, facilities, treatment and care of an NHS hospital combined with the hospitality, speed and service of a private centre. By integrating our NHS and Private Care services, The Royal Marsden benefits from economies of scale, greater purchasing power, lower overheads and the ability to attract world-leading consultants who can conduct their NHS, private and research practices under one roof. These benefits are passed on to the patient, with access to the latest treatments and expert clinicians and their cancer pathways being conducted in one place.
In addition, all of the profit generated by The Royal Marsden Private Care is reinvested into the NHS Foundation Trust. This money is used to fund new technology, equipment and research, and to continuously improve quality of care for both NHS and private patients alike.