In-hospital care

I'm Ben Challacombe, I'm one of the consultant urologists at Guy's and I'm also one of the robotic surgeons.

So the robotic surgery programme at Guy's and St Thomas' has been going now for 13 years.

It's the longest programme in the UK, almost 3,000 patients have been treated with robotic surgery here.

We treat mainly prostate cancer in terms of the highest percentage, but also have a very strong programme for both bladder and for kidney cancer, and some other rarer cancers that we see within the urological group.

So robotic surgery is really just a variation on standard laproscopic, ie: keyhole surgery.

It uses the same small holes in the patient's skin, the same small scars, but instead of long, straight instruments controlled by the individual surgeon that can kind of just go left and right and up and down, little tiny arms go in that are controlled by the surgeon but away from the patient.

These arms have actually got a higher range of motion and they're connected to a machine, called the robot, and the surgeon actually operates from a console that can be several metres away from the patient.

Robotic surgery has many patient benefits really, from the point of view of the minimally invasive aspects of the surgery. So, obvious things such as quicker recovery smaller scars, less blood loss, less pain, earlier return to work and less stay in hospital but also we think that there are some aspects of the operations that we can actually do much better with a robotic approach than either a laparoscopic and occasionally also than a traditional open approach, because really of the dexterity of the robot and the precision and the 3-dimensional vision that it gives you.

So we really have all of the technology at our fingertips to provide the best treatment for our patients.

Delivering a baby by emergency c-section in late labour can be challenging as the baby's head can become deeply impacted in the mother's pelvis. Some degree of difficulty, referred to as 'impacted fetal head' (IFH) is experienced with around half of babies born this way.

IFH can lead to significant harm to the mother and baby and tragically several babies are brain damaged or die as a result each year in the UK alone. Even when harm is avoided, the experience can be scary and stressful for the obstetric team, mother and her birthing partner.

The Tydeman Tube is a new device designed to support safer delivery of babies when IFH is anticipated or encountered. An assistant uses the device to gently lift the baby's head out of the birth canal while the obstetrician performs the c-section.

The Tydeman Tube is the only device that can be used when IFH is encountered unexpectedly. In simulator studies, it achieved greater elevation of the baby's head than alternative methods and when used clinically it was found to be easy to use and effective.

The Tydeman Tube has been developed by Dr Graham Tydeman, formerly of NHS Fife, and a team of obstetricians from Guy's and St Thomas' NHS Foundation Trust and King's College London, with funding from the Guy's and St Thomas' Charity and support from CITI.

The device is patented in Europe (including the UK), USA and Australia, and has registered trademarks and registered designs in the UK and Europe. With the team's support, CITI is licensing the Tydeman Tube to a medical device manufacturer to make sure this device is available in obstetric units at Guy's and St Thomas' and around the world.

For more information watch Introduction to the Tydeman Tube video on YouTube.