Page last updated at 01:29 GMT, Saturday, 20 February 2010

Robot surgeon offers scarless surgery for parathyroid

By Jane Elliott
Health reporter, BBC News

Parathyroid gland. Pic: Anatomical travelogue/SPL
The parathyroid glands are small glands in the neck that produce parathyroid hormone

When 67-year-old Margaret Mulloy started feeling tired and anxious she put it down to her age.

But a routine blood test revealed the Londoner had a problem with four tiny glands in her neck, which needed to be removed.

The four pea-sized parathyroid glands control the level of calcium in the blood.

When the glands become overactive, calcium levels rise, thereby weakening bones, raising blood pressure and causing kidney stones.

In the past Margaret would have faced a neck scar of at least 5cm (2in).

But she became one of the first patients in the UK, possibly the world, to have scarless neck surgery after surgeons used the da Vinci robot.

The system allows the surgeon to operate through smaller scars within the body with more accuracy compared to conventional surgery.

Avoiding a scar is a main benefit
Neil Tolley

Ear Nose and Throat (ENT) consultant Mr Neil Tolley, who led the team at St Mary's Hospital, part of Imperial College Healthcare, said the robot enabled them to make one small cut below the collar bone and three incisions near the arm pit.

"Avoiding a scar is a main benefit," he said.

"We are achieving the same surgical goal without a scar on the neck.

"We have used this technique on six patients so far."

Surgical precision

ENT research registrar Mr Asit Arora said all procedures had been successful with minimal blood loss.

Judith Taylor
Judith Taylor has a neck scar

Robotic-assisted surgery has been used for several years in heart and prostate operations.

The principal benefits of telerobotic surgery are improved surgical precision and minimal access capability.

It gives the surgeon 3D vision, reduces hand tremor and improves manual dexterity.

Margaret said it had certainly made a big difference to her.

"It is marvellous," she said.

"I have just got a little mark, but if I had it the old way I would have had a scar. This is much better especially for a younger person."

She added that since her surgery her blood pressure had also dropped.

Human surgeons

Judith Taylor had neck surgery the old-fashioned way several decades ago and was left with a large scar.

"I had surgery for thyroid cancer 45 years ago when I was 15 and was very self-conscious about the scar when I wore low-cut dresses or a bikini," said the trustee of the British Thyroid Foundation, a charity which supports those with thyroid disorders.

Two more operations on her neck followed, including surgery to remove an over-active parathyroid gland.

She said she would welcome a technique that reduced scarring, but what was more important to her was that everyone needing thyroid or parathyroid surgery had access to highly-skilled surgeons whether robotic or human.

She added: "I now wear my scar with pride, and the good news is that, thanks to my surgeons, I have my voice, I still sing as a hobby, I have two remaining functioning parathyroids - and I have my health."



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