Minimally Invasive Therapies and Digital Technologies

Theme Leads:  Professor Tze Min Wah and Mr Ryan Mathew

 

Background

Technology is transforming surgical care, enabling therapies to be delivered with greater precision, minimal trauma, and improved outcomes (https://futureofsurgery.rcseng.ac.uk). Patients benefit from less morbidity, shorter lengths of stay and faster recovery, whilst hospitals benefit from reduced costs, greater efficiency and cost-savings.

Digital enhancement along the entire surgical pathway, combined with real-time intra-operative data and robotic assistance, are pushing the boundaries of surgical capability. Rich patient datasets combined with artificial intelligence/machine learning are enabling us to better understand the complexities of surgical care and tailor treatments to individual patient needs.

The integration of digital technologies, including immersive realities and remote patient monitoring, into clinical practice and the benefits they bring for preoperative education, operative planning, surgical rehearsal and performance, and post-operative recovery are only just beginning to be realised. The adoption of remote proctoring provides accelerated learning, whilst reducing the carbon footprint of traditional training methods.

Advances in mobile digital technologies opens the reality of “virtual wards”, allowing patients to be discharged quickly and safely from hospital into the community, freeing valuable hospital resources, or to be monitored and treated in their own homes without the need for repeat hospital visits.

 


 

Areas of Focus

This theme will bring together clinicians, academics, industry, professional bodies, and the public and patients to harness the power of digital, data, and surgical devices and accelerate innovation uptake into the NHS based on robust evidence of safety and cost effectiveness. It will seamlessly bridge the two other technology themes, allowing more patients with early-stage disease to benefit from minimally invasive treatments, spend less time in hospital, and recover safely in the community.

We will work across:

  • Orthopaedic,
  • Transplantation,
  • Emergency Surgery,
  • General Surgery,
  • Vascular,
  • Colorectal,
  • Liver/Pancreas/Gallbladder (HPB) and
  • Neurosurgery.

 


Projects

 

Development of technology for anastomotic leak detection for colorectal surgery

Using virtual and augmented reality 3D holographic images for Hepatopancreatobiliary Surgery

Prospective multicentre open clinical study to assess the safety performance and durability of the TIES® transcutaneous titanium implant in patients requiring a permanent ileostomy

A validation study of contactless remote photoplethysmography for vital sign monitoring

3D navigation system that enables real-time anatomical tracking during spinal surgery

Sub-dermal imaging modality for diagnosing peripheral artery disease

An inexpensive, fast and reliable estimation of cardiorespiratory fitness VO2-max estimation

Continuous monitoring of drain pH and electrical conductivity in patients with gastrointestinal anastomosis

Surgically implanted body-computer interface for monitoring of disease via electrical signals

Using Behavioural AI for the Early Detection of Brain Cancer

Educating healthcare workers and patients using immersive technologies

Case Studies

 

A robotic camera system that makes bowel examinations easier for patients and more efficient for hospitals.

Diseases of the large bowel (colon) are a major burden on the NHS. They are usually diagnosed using a camera test (colonoscopy). Around 200,000 NHS colonoscopies are performed each year, each costing ~£372 per patient. Colonoscopy can be uncomfortable for patients and may require time off work or care from family members during preparation and recovery. Colonoscopies can lead to a life changing diagnosis or reassure patients that they don’t have disease. A shortage of specially trained healthcare professionals who can perform colonoscopies has led to long waiting times and possible delays in diagnosis and treatment.

Robotic systems are more precise, safer, do not suffer from tiredness, can operate 24/7 and reduce complications from human error. But robots are expensive, and their benefits must be balanced against their increased costs.

An award winning (KUKA Innovation Award 2019) new robotic magnetic colonoscope (camera) has been developed by engineers at the University of Leeds, clinicians at LTHT, and industry (Atlas Endoscopy). Our robot’s advanced design and operating features mean it is kinder for patients because the low volume camera is gently pulled around the bowel rather than pushed by a camera operator (endoscopist). It is also easier to use, and potentially better at detecting disease than standard colonoscopy. Its components are cheap and might save the NHS money. In the future, examinations could be performed with minimal human assistance (semi-autonomously), meaning more examinations for less money. Our robotic colonoscope is undergoing first-in-human clinical studies in LTHT, funded by Cancer Research UK (£1.2m) and supported by Leeds CTRU and Leeds NIHR Surgical Technologies MIC, to determine its performance in routine clinical work and settings.

Working with the HRC-ASC, we will develop and commercialise our robotic colonoscope, benefiting from the HRC’s expertise in clinical and economic evaluations for bowel disease (doi.org/10.1001/jama.2017.7219) and access to expertise in market access and medical device regulations. Our previous experience in evaluating robotic medical systems, taking into account “real world” factors, such as time taken for surgeons to become experts and perform robotic surgery safely, has been used by healthcare providers across the world to plan how best to deploy surgical robots, and by other manufacturers (CMR Surgical, UK, and Distalmotion, Switzerland) to develop low-cost systems that will mean more patients can benefit from robotic surgery.

Fellowships

 

Coming soon…..

Publications

 

Manuscript Accepted:  ‘Management of subcutaneous abscesses: Prospective cross-sectional study (MAGIC)’

Patient and Public Involvement/Engagement

 

Coming soon…..

Events

 

Coming soon…..