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An anonymous HK$18 million donation has allowed the Faculty of Medicine at The Chinese University of Hong Kong (CUHK) to purchase the latest version of the world acclaimed da Vinci® S Surgical System for robotically assisted surgery at the University’s teaching hospital, the Prince of Wales Hospital. CUHK surgeons have already successfully carried out a wide range of minimally invasive procedures using an earlier version of the da Vinci® Surgical System, installed two years ago in the hospital’s operating theatre. Now, this generous and far sighted investment in even more advanced robotics will further enhance surgical outcomes and allow new training opportunities to be brought on stream.

This latest version incorporates high definition endoscopic video technology. The surgeon at his control console now sees a superior 3D high definition image of the operating field. Large interactive plasma display panels provide assisting clinicians and staff with exceptionally clear high contrast images of the same field. A further advantage is an additional robotic arm. While the first three arms together control the miniaturized instruments and the laparoscopic camera that are placed in the surgical field via pencil sized “keyhole” incisions, the extra fourth arm typically controls the instruments used to retract adjacent tissues and anatomy. This gives the surgeon a “third hand” and normally obviates the need to have a second surgeon in attendance.

While the earlier version significantly improved surgical outcomes and patient experiences at the Prince of Wales Hospital, its operating theatre location ruled out its use for training purposes. The installation of the new robot, however, has allowed the earlier version to be relocated to the existing state-of-the-art CUHK Jockey Club Minimally Invasive Surgical Skills Centre (Jockey Club MISSC).

A constant stream of Hong Kong, Mainland and regional surgeons will learn the correct use of the robotic system as well as keeping up-to-date with the other current minimally invasive surgical techniques which the Jockey Club MISSC was specifically designed to teach. With such top-flight opportunities on their doorstep, surgeons will no longer have to travel long distances overseas to approved centres for product training and upgrading, and training costs will be dramatically reduced. The Jockey Club MISSC will become only the second centre outside North America to be approved for system and procedure training on the da Vinci® Surgical System by manufacturers Intuitive Surgical®, headquartered in California. The first centre is in Strasbourg in France .

Professor Andrew van Hasselt , Chairman of the Department of Surgery said, “Thanks to this philanthropist’s extraordinary generosity, we can now redeploy our existing robotic surgical equipment and leverage the multi-disciplinary experience so many of our surgeons have already gained with such systems. Our co-operation with Intuitive Surgical® puts us ahead not just in Hong Kong but on the global map, and the upgrade to a da Vinci® S will offer patients at Prince of Wales Hospital the very latest and best in surgical facilities.”

Professor Enders Ng, Director of the Jockey Club MISSC said, “The assistance of the robot allows the surgeon to exercise ultra-fine control over the miniaturized instruments. Many very complex minimally invasive operations can therefore be safely and confidently carried out as a matter of routine, given the correct technical training, which we can now so readily provide.”

In an associated initiative, plans are being drawn up to enhance the Jockey Club MISSC’s existing video infrastructure in order to bring it into line with the 3D High Definition standards of the latest da Vinci® S Surgical System. This upgrade will make the Jockey Club MISSCthe ideal training ground for the minimally invasive surgeons of tomorrow.

“The latest da Vinci® offers surgeons a superb view of the operating field,” noted Professor Sidney Yip, Chief of Urology in the Department of Surgery. “This further enhances the precision given by robotics. In a radical prostatectomy, for example, we can readily visualize the tissue planes and the neurovascular bundles and so carry out meticulous dissection of the prostate and delicate surrounding structures. This leads to better cancer control, and can also help to preserve sexual function and improve urinary function. ”

The robotically assisted approach to prostate cancer has already become the “gold standard”—the procedure of choice. Robotics is regularly making newer and more complicated procedures possible in such areas as general surgery, paediatric surgery, gynaecological operations and cardiothoracic surgery.

Professor van Hasselt concluded by saying how proud he was of the readiness and skill with which CUHK’s trained and talented surgical teams had already embraced robotics over the previous two years. CUHK’s overarching and realistic vision now is for gold standard procedures and experiences to become the norm for all complex surgery carried out in its teaching hospital—and beyond.