Live link to India from theatres

The audience at Scunthorpe who watched the special teaching session

A teaching session with a difference saw surgeons at Scunthorpe hospital stream two operations live to India!

The colorectal team – working with theatre staff – provided a unique masterclass session to surgeons at The Indian Association of Gastrointestinal Endosurgeons (IAGES).

The team from Northern Lincolnshire and Goole NHS Foundation Trust (NLaG) beamed live pictures while they carried out two keyhole procedures – both to remove polyps from the bowel. They demonstrated two different ways of doing this using laparoscopic – keyhole – equipment.

Consultant colorectal surgeons, Mr Muzaffar Ahmad and Mr Murthy Nyasavajjala, co-ordinated the event which also saw the whole team – specialist nurses, junior operating department practitioners and business managers – also watch the live feed.

Mr Ahmad said: “The aim of the event was to show our colleagues in India how we use keyhole surgery techniques even to do quite major surgery. It is far less invasive for our patients, therefore reducing the risk of infection and cutting the amount of time they have to stay in hospital.”

As the first patient was prepared for surgery, the Indian delegates received background information about the case from a consultant talking from a meeting room. He also briefed the colorectal team who were watching the procedure at Scunthorpe.

The teaching session then moved live to the theatre where Mr Ahmad and Mr Ramana Kallam were demonstrating CALP – colonoscopic assisted laparoscopic polypectomy. This is a new minimal invasive approach to removing polyps from the bowel which can be pre-cancerous.

The procedure uses a camera which is inserted into the patient’s back passage, as well as a camera which goes in through a small hole in the stomach. Mr Ahmad said: “By going in using two cameras we can view the bowel from the inside and from the outside of the organ.

“Using the colonoscopy the polyp was located, then pushing on the bowel, I was able to get hold of it, and using a device which staples the area, I cut it in the middle and removed it. By using staples it immediately seals the wound, which reduces the risk of infection as there are no open cuts made to the bowel.

“Our colleagues in India were really interested to see this technique as it is something they have never seen before. They asked lots of questions about the equipment we were using as well as the technique.”

CALP is effective in removing large, sessile polyps (which can blend in with the lining of the organ), or awkward localised ones.

The second operation saw Mr Ahmad use TEMS (transanal endoscopic micro surgery) – again this was using keyhole equipment.

Mr Ahmad said: “TEMS is used to remove non-cancerous rectal polyps using a microscope and other instruments designed specifically for this purpose. It allows me to perform the surgery through the back passage inside the rectum.

“The beauty of it is that is requires no cuts as the procedure is done completely through the back passage. Again, a camera was used to locate the polyp and then using a cauterising tool I removed the affected area.”

Mr Ahmad said: “It was really exciting to be able to show eminent surgeons in India how we do things the NLaG way. Our prime focus in always on patient safety, and making sure we provide the best care for them.

“Using keyhole surgery reduces the risk of infection, and drastically cuts down on the amount of time the patient has to stay in hospital as we are not cutting open their stomach. It was a pleasure being able to show this technology to our peers in India.”

Mr Nyasavajjala said: “It has been a real team effort to pull this off. The theatre staff have supported us every step of the way and have been brilliant in helping us to showcase what we do.”

He also wanted to thank account manager Edward Haynes and head of OR1 David Clarke from Storz as they set up the technology for the live link.

Michael Searby, colorectal clinical nurse specialist, was sitting in the audience at Scunthorpe. He said: “I speak to patients when they are coming through clinic, but to be able to actually see what the surgeons do when they are operating on them was brilliant. It gave us a unique insight into what happens. I learned a lot.”

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