A pioneering remote robotic surgery, the first of its kind in the UK, has been hailed as a significant medical "milestone" after a London-based surgeon successfully operated on a prostate cancer patient located 2,400km away in Gibraltar.
Paul Buxton, 62, who moved to Gibraltar from Burnham-On-Sea four decades ago, underwent the procedure.
He reported feeling "fantastic" just four days post-surgery, describing his decision to participate as a "no-brainer".
Mr Buxton told the Press Association he was happy to be the "guinea pig" patient, adding that the operation has taken Gibraltar from the "Championship to the Champions League" in terms of access to surgery.
Leading robotic urological surgeon Professor Prokar Dasgupta performed the operation, confirming to PA that the surgery proceeded as planned with a minimal lag of just 0.06 seconds between the surgical tool in London and the robot in Gibraltar.
The professor of urology said that it was “almost as if I was there” when operating on the patient.
Mr Dasgupta said the procedure, the UK’s first remote telesurgery, was a “milestone”.
The only hospital in Gibraltar is St Bernard’s at Europort.
But residents with more complex needs would usually travel further afield, including to the UK for NHS care for those eligible.
After a shock prostate cancer diagnosis after Christmas, Mr Buxton was expecting to join the NHS waiting list and to travel to England 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.
“Normally, any major surgeries, apart from minor stuff, maybe hernias and things like that, you end up having to go to either London or Madrid.”
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,” he added.
Mr Dasgupta, who leads The London Clinic’s Robotic Centre of Excellence, said: “The surgery was a milestone. It went extremely well.
“We operated on an NHS patient in Gibraltar from The London Clinic 2,400km away using a robot with a 3D HD camera with four arms.
“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 60 milliseconds.”
A team on the ground in Gibraltar was standing ready to take over as a precaution in case the connection dropped.
The London Clinic and Gibraltar Health Authority collaborated on the project, and the Toumai Robotic System, made by Microport, was used to perform the operation.
Mr Dasgupta said that patients in remote areas do not always have access to the best healthcare.
The remote robotic surgery means that patients can be saved the “vast expense and inconvenience” of travelling for care, he added.
“This gives us the opportunity to treat patients in remote areas and smaller communities by literally being able to take the best surgeon anywhere,” he added.
“The technology now exists to provide this benefit to patients.”
Mr Buxton was the first of two test cases and the first official surgery took place on Wednesday March 4.
Mr Dasgupta performed another prostatectomy – a surgical removal of the prostate – on an unnamed 52-year-old man, also in Gibraltar.
Speaking after the surgery on March 4, Mr Dasgupta told PA: “This is a historic moment – the first telesurgery procedure from The London Clinic to Gibraltar, 2,400 kilometres away. Unbelievable.
“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.
“This is very good news for patients in Gibraltar and other remote areas.”
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.
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.
Al Russell, chief executive at The London Clinic, said: “The London Clinic is proud to be part of medical history and we have a strong reputation for medical firsts.
“We hope more patients will be able to benefit from this incredible medical breakthrough.”
Gibraltar minister for health, Gemma Arias-Vasquez, added: “This is a landmark moment for the Gibraltar Health Authority and for our patients.
“To deliver a complex procedure in Gibraltar with the operating surgeon based in London shows how technology, investment and the expertise of our clinicians are transforming healthcare.”
The surgery was supported global technology services provider, Presidio.
New prostate cancer drug showing ‘remarkable’ results during clinical trial
The diet which can reduce the risk of five cancers by almost a third
European city sends hundreds of robots to live with lonely residents
Alarming amount of microplastics found in prostate cancer tumours
NHS urged to approve new treatment for aggressive cancer
A virus without a vaccine is spiking throughout California. Here’s what to know
