Pictured: Consultant Head and Neck Surgeon, Ms Nazeem Ghazali

The rapid evolution of technology has had a significant impact on our daily lives affecting communication, education, business and even surgery.

Whilst studying for the Head and Neck Oncology Fellowship at The University of Maryland Centre in Baltimore, Dr Naseem Ghazali was introduced to the DaVinci robots that would transform the status quo of surgery.

At ELHT we now have our own nine foot high, three armed robot affectionately known as Leo to theatre staff. Dr Naseem Ghazali joined the Trust as an integral part of our team bringing with her valuable experiences from America.

“I chose to work at ELHT because I was enthusiastic about the plans for robotic surgery; I was excited about working with a future-proof technology, as well as the research and development opportunities.

It was only when I first sat at the console of the robot that I was able to fully appreciate its potential. The clarity of the live video feed from the laparoscope cameras is truly staggering.

The thing that struck me the most was being able to see the smallest shake in your hand; you can see even the slightest of tremors. The robot allows clinicians to see high resolution, three dimensional images that are so defined that you feel as though you have been transported to the back of the patient’s mouth.

I realised that this was going to revolutionise the way we remove cancers.

The instruments we are using with this piece of kit are microscopic tools, smaller than a hair line, resulting in incredible precision and accuracy. The robot allows us to transcend the fundamental challenges of conventional surgery. It can perform abnormal movements that a human wrist would not allow. This increases the range of options when planning surgery.

The impact the robot’s capabilities has on recovery time is astonishing. Conventional surgery was drastic and recovery time was lengthy with patients struggling to speak, drink or swallow. However, patients who have received robotic surgery are sometimes being discharged within a week and are quickly regaining functionality.

As a clinician your main objectives are firstly to remove the cancer but more importantly you want your patient to have the best quality of life after the procedure.

Since the HPV epidemic the number of younger patients with throat cancer has risen. Many of these patients are in their early 40s. The epidemic changed the landscape of throat cancer. Drastic surgery would often mean that patients would not return to the same lives they had before.

From the result of clinical trials we are now able to see the long term effects of chemotherapy and radiotherapy on the body; dry mouth, scarring and issues with swallowing. In the long term, this kind of treatment only preserved the organ but not retained its function.

What is exceptional about the robot is that it means we can avoid exposure to chemotherapy whilst massively reducing the effects of conventional surgery. A faster recovery time allows younger patients to return to their lives, jobs and families within a few months.

The end goal is to see these patients return to their lives where they can continue to contribute to the community.

Head and neck cancer affects a person significantly. The face that they present to the world has changed and this can be a devastating hit to their identity. Difficulties with speech and eating can often make patients feel isolated and uncomfortable in social settings.

It is a privilege to treat these patients and be part of such a significant journey with them. The emergence of robotic surgery is moving us towards a future that goes beyond living with cancer.