Gibraltar patient in ‘milestone’ first remote robotic surgery

By Ella Pickover, Press Association Health Correspondent, and Chronicle staff

The first UK remote robotic surgery has been hailed as a “milestone” by medics who operated on a patient in Gibraltar.

A surgeon in London operated on a patient with prostate cancer who was some 2,400km away in Gibraltar, thanks to a new robotic surgical platform in St Bernard’s Hospital.

The pioneering procedure went “extremely well”, with patient Paul Buxton reporting feeling “fantastic” just four days after the surgery.

Mr Buxton, who is originally from Burnham-On-Sea in Somerset but moved to Gibraltar 40 years ago, said that it was a “no-brainer” to be involved.

The 62-year-old told the Press Association that he was happy to be the “guinea pig” patient, saying the operation has taken Gibraltar from the “Championship to the Champions League” in terms of access to surgery.

He was operated on by leading robotic urological surgeon Professor Prokar Dasgupta, who told PA the surgery went to plan with a lag of only 0.06 seconds between the surgical tool in London and the robot in Gibraltar.

Mr Dasgupta has since performed another prostatectomy – a surgical removal of the prostate – on an unnamed 52-year-old man, also in Gibraltar.

The professor of urology said that it was “almost as if I was there” when operating on the patient, describing the procedure as a “milestone”.

“This is a historic moment – the first telesurgery procedure from The London Clinic to Gibraltar, 2,400 kilometres away. Unbelievable,” he told PA.

“It went very well.”

“We used a robot and a very specialised connection between London to Gibraltar didn’t fail at all.”

“The time delay between the two sides fools my brain into thinking I’m in Gibraltar.”

He added: “I think it is very, very exciting, the humanitarian benefit is going to be significant.”
The console in the UK was connected to the robot in Gibraltar via fibre optics, with a backup 5G connection.

While the GHA’s robotic surgical platform had already been used by local surgical teams for operations, this was the first time a procedure of this kind was performed remotely by a surgeon operating from the UK.

“The distance between London and Gibraltar is approximately 2,400 kilometres, and I am advised that this represents the furthest distance over which remote telesurgery has ever been successfully carried out in Europe,” said Health Minister Gemma Arias-Vasquez.

“For the avoidance of doubt, and to ensure the highest standards of patient safety at all times, the telesurgery is undertaken with a consultant surgeon and a full surgical team physically present in Gibraltar who are able to take over and complete the procedure immediately should the remote connection be interrupted for any reason.”

“This is therefore a huge and genuinely historic milestone for the GHA and for healthcare delivery in Gibraltar.”

“It shows the direction of travel for the GHA going forward, to be leading in technology.”
After a shock prostate cancer diagnosis after Christmas, Mr Buxton was expecting to have to travel to the UK for care.

But he was given the opportunity to be the first patient to have the treatment remotely and jumped at the chance.

“A lot of people actually said to me: ‘You’re not going to do it, are you?'” he told PA.
“I thought, ‘I’m giving something back here’.”

“I love football – we’ve literally gone from being in the Championship to the Champions League as far as surgeons are concerned.”

Mr Buxton, who owns a transport company, added: “If I hadn’t gone for the telesurgery in Gibraltar, then I would have had to have flown to London, I would have had to go on the NHS waiting list, get the procedure done and I would have probably been in London for three weeks.”

“So I thought: ‘this is a no-brainer’.”

“And it is pioneering for Gibraltar, because you don’t need to leave Gibraltar.”

He said he was “really well looked after” adding: “I was feeling fantastic four days after the operation.”

“It’s been a privilege to be part of medical history.”

Mr Dasgupta, who leads The London Clinic’s Robotic Centre of Excellence, said: “The surgery was a milestone. It went extremely well.”

Mr Dasgupta operated from The London Clinic using a robot with a 3D HD camera with four arms that was recently purchased by the GHA thanks to support from individual and corporate donors, coordinated by Prostate Cancer Gibraltar, also a part sponsor.

“The robot is completely controlled from a console, which is like a computer console, using high-speed lines with a time delay of, would you believe it, only 0.06 seconds, that’s 60 milliseconds,” he said.

The remote robotic surgery means that patients can be saved the “vast expense and inconvenience” of travelling for care, Mr Dasgupta added, reflecting on the potential for telesurgery in other areas too.

“This gives us the opportunity to treat patients in remote areas and smaller communities by literally being able to take the best surgeon anywhere.”

“The technology now exists to provide this benefit to patients.”

Mr Dasgupta will perform the procedure again on March 14, which will be live-streamed to 20,000 world-leading urological surgeons at the European Association of Urology congress.