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Ireland's first digital surgery unit opens at the Mater in a bid to improve cancer patient outcomes

In a visit to a live operating theatre this morning surgeons explained how it works to TheJournal.ie

A team of surgeons, doctors, and data analysts will work on the three-year project.
A team of surgeons, doctors, and data analysts will work on the three-year project.
Image: Shutterstock/Gorodenkoff

A €7.7 MILLION euro research project, which aims to significantly improve outcomes for cancer patients, has been launched at the Mater University Hospital in Dublin. 

It comes in the form of Ireland’s first digital surgery unit, a collaboration between the hospital, the Royal College of Surgeons, and IT company IBM.

The unit was awarded €5.7 million in funding from the government’s Disruptive Technologies Innovation, and a further €2 million from industry partners. 

New visual and artificial intelligence technology will allow surgeons in operating theatres to make quicker and more accurate decisions, reducing post-surgery complications and significantly reducing the risk of cancers returning. 

A three-year trial will see the technology applied to colorectal surgeries, with a view to the same approach being applied to other cancers, including lung and liver cancer. 

Colorectal cancers are the second most common cancers in both men and women, after prostate and breast cancer, and affect 2,700 people in Ireland every year. 

TheJournal.ie visited the hospital during a live colorectal procedure, where Professor Ronan Cahill, who is spearheading the project, explained how it works, and the major benefits it will have for cancer patients in Ireland. 

“All keyhole operations use a camera to look inside a person, and the surgeon makes judgements on what they see in tissues in order to direct the operation.

“We can get a lot more information out of that if we use a couple of smart tools. If we give a simple and safe dye, we can look to see colour change in the tissue which reflect the nature of [the cells].

“But using dyes means sometimes the colour changes quickly, so therefore we need a bit of help in interpreting them. We can use basic maths, and advanced analytic techniques and software to really change a visual interpretation into a numeric score.”

Image from iOS (2) Prof Cahill, with Mater CEO Gordon Dunne, explaining how the unit works.

Cahill explained that during these types of surgeries, a dye is pumped through the body which highlights the cells that are abnormal and cancerous, but that the surgeon relies on their own experienced judgement to decide what cells should be removed, have a biopsy, etc.

There remains a risk that some parts of a cancerous tumour may not be immediately visible when the dye is injected, meaning it could be left behind while the rest of the tumour is removed.

This can eventually grow, meaning the cancer, which had been operated on, remains, but this new computer software will use a “numeric score” and “analytics” to inform the surgeons decision, because it registers elements including the spread of the dye that may have been missed. 

“It is to help support the decision that you have otherwise made on the basis of your judgement and training.

But this still remains a subjective judgement, and this [technology] is to provide a support to these decisions, which in surgery need to be made in moments. 

“And to maybe personalise that decision to that one person rather than going on the probabilities of what works for most people.

“That’s really what digital surgery is allowing us to do, to personalise the decisions we’re making to that specific person, at that specific time of the operation.”

Complications 

Following colorectal surgery, patients are at risk of developing other issues including peritonitis or septicemia. 

That can occur in around 10% of patients, according to the team working in the Mater University Hospital, who with this new technology are hoping it will reduce it to below 3%. 

Cancer surgeries need the disease taken out and tissues put back together to restore the function of the organs, and we’re already seeing we’re making better decisions in the safety and the healing after the surgery.

“The point of the grant, and the research project working with IBM, is really to accelerate that into that field of cancer diagnostics, but then also real-time information and feedback that can allow those decisions to be made better, quicker, faster.”

“[These surgeries] are mostly done in the cancers, of which there are eight, and there are around 100 or so operations each year – we are already using that to help us make better quality decisions.

“The purpose of this [funding] is for colorectal cancer but we are constantly talking about it being applicable to every disease that requires a major operation, so lung cancer, or liver cancer… as well as other things like plastic surgery.”

The trial of the project has three years to be completed with the results informing a decision to widen the use of this technology in other surgical procedures.

“I’ve been working on this for over a decade in both Strasbourg and Oxford, where I trained, so we’ve been working alongside the camera making companies for quite a while, making sense of how this works,” Cahill said. 

“The concept here is using technology, which surgeons have always done, mostly mechanical instruments but here we’re using 21st century instruments to make for better patient outcomes.”

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