Development of minimally invasive surgery

Increasing treatment options allows for therapy to be personalised and tailored for individual patients. This approach is highlighted through two recent developments at St Mark’s Hospital; FLEX and TASER.

The FLEX technique (full thickness laparoendoscopic excision), developed by Professor Robin Kennedy, involves removal of a small disc of bowel rather than a long segment. This avoids the short term side effects of more conventional operations, and the longer term disadvantages of losing more bowel. This technique was introduced into clinical practice in 2014 and will be further developed over the next 5 – 10 years in order to apply it to patients with early cancer, enabling them to avoid major surgery.

The TASER technique (transanal submucosal resection), developed by Professor Brian Saunders and Mr Janindra Warusavitarne, involves the removal of large polyps in the rectum without the risk of major bowel surgery. It has gained both national and international interest.

The Challenge

Improve patient outcomes and experience.

The Aim

• Increasingly develop the expertise and techniques of both the surgeon and the endoscopist
• Install the latest robotic technology and integrate it with the novel fusion of laparoscopic and endoscopic surgery that has been developed at St Mark’s. It will allow us to advance surgery performed via natural orifices (transanal surgery) which will minimise scarring and ensure best outcomes for patients, with reduced complications
• Further develop the localised excision techniques within the colon (FLEX) by designing and testing equipment that will allow the technique to be refined and become widely available
• Develop methods of testing lymph nodes attached to the colon in order that they no longer need removal during the treatment of early bowel cancer. This may require new surgical methods of lymph node identification, or the testing of genetic or biological markers that allow us to modify and reduce surgery